St. Charles Borromeo Religious Education Registration Form 2025-2026
Classes available for children and teens in grades 1-10
Student's Name
*
First Name
Last Name
Date
*
-
Month
-
Day
Year
Date
Date of Birth
*
-
Month
-
Day
Year
Date
Grade
*
Student's grade level in August 2025
School
Has your child been baptized?
*
Yes
No
Name of Church of Baptism
City and State of Church of Baptism
Approximate Date of Baptism
Date, or year, or how old your child was are all helpful
Other Sacraments Already Received:
Reconciliation
Eucharist
Confirmation
Father's Name
First Name
Last Name
Father's Email
Father's Phone Number
Please enter a valid phone number.
Mother's Name
First Name
Last Name
Mother's Email
Best email address to use for reminders and to send timely information
Mother's Phone Number
Please enter a valid phone number.
Family/Student Address
*
Street Address
Street Address Line 2
City
State
Postal / Zip Code
If there is a second parental address please enter it here:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
At which parish are you registered?
*
This is very important with more than one parish being in the same program. If you aren't yet registered at a parish simply type 'none'.
Emergency Contact Name
*
First Name
Last Name
Relationship
Phone Number
*
Please enter a valid phone number.
Preferred Medical Facility
Name of Physician/Pediatrician
First Name
Last Name
Phone Number
Please enter a valid phone number.
Any Allergies or Medical Conditions?
*
Yes
No
Please give any details we need to know about your child's allergies or medical conditions
Do you want to add something about your child?
I, undersigned, agree with the following statements:
*
I am the parent/guardian of the child indicated above.
If emergency medical care is needed and I am unavailable, I authorize the supervising catechist to seek medical treatment for my child.
I am giving my permission to take my child's pictures for classroom projects.
I am giving my permission for my child's picture to be used in the bulletin and on the church website/newsletter.
I recognize the importance of attend Mass on Sundays and Holy Days and intend to bring my children to Mass on these days to help them to live out their faith.
Submit
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