CEP | Registration Form

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2026 - 2027

This registration form is only for the following children’s faith formation programs for the upcoming year:

–Pio Kids: for Pre-K through Kindergarten

–CEP (Catholic Education Process): for students in 1st through 5th grade

–OCIA Adapted for Children: for children of catechetical age (7 - 17 yrs old) who are in need of Baptism

–Teen Confirmation: for high school candidates who have already completed one full year of Pio Youth High School (Life Teen) with at least 85% attendance. Please note, participation in middle school youth ministry (EDGE) does not count toward the two-year Confirmation preparation requirement.

Please read carefully:

–This form does not register students for Middle School, High School, Confirmation, Youth Group, or any programs outside of those listed above.
–Registration is considered complete only when this form is fully submitted and all required documentation and fees are received.
–All information provided is confidential.

Father's Name

Father's Cell

Please enter a valid phone number.Format: (000) 000-0000.

Father's Email Address

example@example.com

Mother's Name

Mother's Cell

Please enter a valid phone number.Format: (000) 000-0000.

Mother's Email Address

example@example.com

Mother's Maiden Name

Home Address

Street Address

Street Address Line 2

CityState / ProvincePostal / Zip CodeCountry

Emergency Contact Name

Emergency Contact Cell

Please enter a valid phone number.Format: (000) 000-0000.

Authorized Persons for Pick Up

Child Name

First NameLast Name

Child Date of Birth

Date

Child Grade Level

Are there any behavioral, physical, or developmental considerations that would help us better support your child?

Behavioral, physical, or developmental Description (if applicable)

Food Allergies?

Food Allergies Description (if applicable)

List of current or chronic conditions and past injuries the participant has suffered, and other information which may facilitate care in the event of an emergency:

Is there a split custody arrangement for this child?

Child Primary Physician

PCP Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Preferred Hospital in the event of an emergency

Has your child received the Sacrament of Baptism?

Has your child received First Communion?

Has your child received the Sacrament of Confirmation?

Would you like to add a 2nd child?

Child #2 Name

First NameLast Name

Child #2 Date of Birth

Date

Child #2 Grade Level

Are there any behavioral, physical, or developmental considerations that would help us better support your child?

Behavioral, physical, or developmental Description (if applicable)

Child #2 Food Allergies?

Child #2 Food Allergies Description (if applicable)

List of current or chronic conditions and past injuries the participant has suffered, and other information which may facilitate care in the event of an emergency:

Is there a split custody arrangement for this child?

Child #2 Primary Physician

PCP Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Preferred Hospital in the event of an emergency

Has Child #2 received the Sacrament of Baptism?

Has Child #2 received First Communion?

Has Child #2 received the Sacrament of Confirmation?

Would you like to add a 3rd Child?

Child #3 Name

First NameLast Name

Child #3 Date of Birth

Date

Child #3 Grade Level

Are there any behavioral, physical, or developmental considerations that would help us better support your child?

Behavioral, physical, or developmental Description (if applicable)

Child #3 Food Allergies?

Child #3 Food Allergies Description (if applicable)

List of current or chronic conditions and past injuries the participant has suffered, and other information which may facilitate care in the event of an emergency:

Is there a split custody arrangement for this child?

Child #3 Primary Physician

PCP Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Preferred Hospital in the event of an emergency

Has Child #3 received the Sacrament of Baptism?

Has Child #3 received First Communion?

Has Child #3 received the Sacrament of Confirmation?

CEP creates moments and memories. To help capture how God is moving in the lives of the children we serve, we will occasionally take photos and videos during certain gathers.

Parent/Guardian Permission:
Do you give permission for your child/children to be photographed and/or recorded during any Pio Kids, CEP or OCIA Adapted for Children gatherings, and for these images or videos to be used by The Shrine of St. Padre Pio for promotional purposes, including but not limited to social media, parish website, and printed materials?

Parent/Guardian Signature

Signature Date

Date

CATHOLIC EDUCATION PROCESS REGISTRATION FORM

Parent/Guardian Information

Student(s) Information

Parent/Guardian Signature