24-25 Religious Education Registration

Religious Education Registration

Sacred Heart - Shelton
Please feel free to reach out if you have any questions:

sacredheart.shelton.dre@gmail.com
Make Registration Fee Checks Payable to Sacred Heart Parish

You may give them to Chrissy or place them in the Collections basket on Sunday marked “Religious Education”. ($25 per student or $75 per family)
Parent Information
Mother Information

First NameMaiden NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Father Information

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Address

Street Address

Street Address Line 2 or PO Box

CityState / Province

Postal / Zip Code
Emergency Contact

In the event of an emergency, please contact:
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Relationship
Student Information

Please fill out for each child attending Religious Education
Name - Child #1

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Current Grade
2024-2025 School Year
Catholic Baptism?
Name of Church Baptized In
Please include city & state
Date of Baptism

MonthDayYear
Date
Recevied First Reconciliation?
Received First Communion?
Received Confirmation?
Name - Child #2

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Current Grade
2024-2025 School Year
Catholic Baptism?
Name of Church Baptized In
Please include city & state
Date of Baptism

MonthDayYear
Date
Received First Reconciliation?
Received First Communion?
Received Confirmation?
Name - Child #3

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Current Grade
2024-2025 School Year
Catholic Baptism?
Name of Church Baptized In
Please include city & state
Date of Baptism

MonthDayYear
Date
Received First Reconciliation?
Received First Communion?
Received Confirmation?
Name - Child #4

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Current Grade
2024-2025 School Year
Catholic Baptism?
Name of Church Baptized In
Please include city & state
Date of Baptism

MonthDayYear
Date
Received First Reconciliation?
Received First Communion?
Received Confirmation?

Medical Information

*Information listed below remains confidential and will only be used for purposes related to assisting the student as determined by the Director of Religious Education. If none, please put N/A.
Child #1

First NameLast Name
List any chronic health conditions, recent/current serious illness or injury:
If none, please put N/A
List any food or environmental allergies:
If none, please put N/A
List any medications the child is currently taking:
If none, please put N/A
List any educational or behavioral needs (gifted, dyslexic, ADD, slow reader, etc.?
If none, please put N/A
Child #2

First NameLast Name
List any chronic health conditions, recent/current serious illness or injury:
List any food or environmental allergies:
List any medications the child is currently taking:
List any educational or behavioral needs (gifted, dyslexic, ADD, slow reader, etc.?
Child #3

First NameLast Name
List any chronic health conditions, recent/current serious illness or injury:
List any food or environmental allergies:
List any medications the child is currently taking:
List any educational or behavioral needs (gifted, dyslexic, ADD, slow reader, etc.?
Child #4

First NameLast Name
List any chronic health conditions, recent/current serious illness or injury:
List any food or environmental allergies:
List any medications the child is currently taking:
List any educational or behavioral needs (gifted, dyslexic, ADD, slow reader, etc.?
Would you be interested in teaching or subbing? (You can choose more than one.)
If yes, which parent would be interested?
Thank You & God Bless

DRE Chrissy Baker
Should be Empty:

Religious Education Registration

Please feel free to reach out if you have any questions:

Make Registration Fee Checks Payable to Sacred Heart Parish

Parent Information

Emergency Contact

Student Information

Medical Information

Thank You & God Bless