Family Registration Form

St. Pius X Parish School of Religion

Joe Filous, Director of Religious Education

614-866-2859 ext 127

jfilous@spxreynoldsburg.com
Family Registration Form
Family Name
Last Name Only
Home Phone Number
Please enter a valid phone number.
Student(s) Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Father's Name

First NameLast Name
Father's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Father's Phone Number
Please enter a valid phone number.
Father's Email
example@example.com
Father's Religion
Mother's Name

First NameLast Name
Mother's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mother's Phone Number
Please enter a valid phone number.
Mother's Email
example@example.com
Mother's Religion
Public School System Attending
Name of School/District
Information of Child(ren)

Child 1
Child's Full Name

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Male or Female
Academic Grade in Fall
Last Level of Religious Education Completed
Baptism Date and Place
First Eucharist Date and Place
Baptismal Certificate MUST be on file in the Religious Education Office. Please Upload here or bring in a copy.

File should be in pdf, doc/docx format.
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Child 2
Child's Full Name

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Male or Female
Academic Grade in Fall
Last Level of Religious Education Completed
Baptism Date and Place
First Eucharist Date and Place
Baptismal Certificate MUST be on file in the Religious Education Office. Please Upload here or bring in a copy.

File should be in pdf, doc/docx format.
Cancelof

Child 3
Child's Full Name

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Male or Female
Academic Grade in Fall
Last Level of Religious Education Completed
Baptism Date and Place
First Eucharist Date and Place
Baptismal Certificate MUST be on file in the Religious Education Office. Please Upload here or bring in a copy.

File should be in pdf, doc/docx format.
Cancelof

Child 4
Child's Full Name

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Male or Female
Academic Grade in Fall
Last Level of Religious Education Completed
Baptism Date and Place
First Eucharist Date and Place
Baptismal Certificate MUST be on file in the Religious Education Office. Please Upload here or bring in a copy.

File should be in pdf, doc/docx format.
Cancelof

Volunteers
Volunteers are ALWAYS needed and appreciated. All volunteers must be fingerprinted and have a BCI background check and attend the diocesan workshop “Protecting God’s Children.” Please check any duties that interest you.

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