StGertrude-Bay RE Registration

2026-2027 Registration Form
Family Information
Family Last Name:
Preferred Email:
example@example.com
Preferred Phone:
Format: (000) 000-0000.
*If you are new to this program you must include a copy of your child' s Baptismal
Certificate.
Father's Name:

First NameLast Name
Mother's Name:

First NameLast Name
Address:

Street Address

Street Address Line 2

Town / City / ZipState / Province

Postal / Zip Code
Father's Cell Phone:
Format: (000) 000-0000.
Mother's Cell Phone:
Format: (000) 000-0000.
Emergency Contact (OTHER THAN PARENT)

First NameLast Name
Phone:
Format: (000) 000-0000.
Student Information
Name:
Date of Birth:

MonthDayYear
Date
M or F
Grade in Sept.
Name of School:
Name:
Date of Birth:

MonthDayYear
Date
M or F
Grade in Sept.
Name of School:
Name:
Date of Birth:

MonthDayYear
Date
M or F
Grade in Sept.
Name of School:
Do any of your children have any medical condition and/or allergy that we should know about?
If "yes", list condition/allergy here:
Please submit a completed Medical Information Form for your child.
Do any of your children receive any special services from his/her school/district?
If "yes", which Child
Does he/she have an Individual Education Plan (IEP) or 504 Plan?
b. Does he/she receive any of the following services?
My child has the following special need(s) that may impact classroom activities:
Are there accommodations or modifications that can facilitate learning:
Are there any special family situations that we need to be aware?
If "yes", please explain below.
Class Schedule
Please check the day and time of your first choice.
Permissions
I hereby grant permission to the Saint Gertrude Religious Education Program, to take
photographs and make recordings of my children named below, and to use them in original
or modified form in the parish bulletin. Website, Instagram and Facebook page, solely
for the promotion of the Saint Gertrude Parish.
My Name (PLEASE PRINT):
My Signature:
Date:

MonthDayYear
Date
Registration Fee
One child: $225
Two children $275
Three or more children $300
Make Checks payable to St. Gertrude Church
You may make your payment online at
https://giving.myparishsoft.io/App/Form/4bd44869-abf3-44c4-9833-2483e288b1a2 or use the QR code on the website.
Should be Empty:

2026-2027 Registration Form

Family Information

Student Information

Class Schedule

Permissions

Registration Fee