Religious Education Registration 2026-2027

Family Information
Last Name of Family
Primary Contact Email
example@example.com
Primary Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Family Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Father's Name

First NameLast Name
Father's Cell Phone
Please enter a valid phone number.Format: (000) 000-0000.
Father's Email Address
example@example.com
Mother's Name

First NameLast Name
Mother's Cell Phone
Please enter a valid phone number.Format: (000) 000-0000.
Mother's Email Address
example@example.com
Primary Language Spoken by Family
Are you a registered parishioner at St. Susanna?
Are you interested in becoming a catechist?
How many students are being registered?
Registration Payment

Registration payments (full or partial) will be made online at the time of registration for religious education. There are no additional fees for this online payment. Families who cannot pay the entire RE Fee at this time can make a partial payment toward the year's fees in increments of $25.00

Registration Payment

Family Registration

Pay full registration fee today. Choose the number of children being registered below. 1 child - $125; 2 children - $200; 3+ children - $250

$125.00 Quantity

Catechist Registration

I am serving as a Catechist for the Sunday morning or evening religious education program.

Free

Partial Payment

I would like to register my child(ren) today and make a partial payment toward their total fees. Payments may be made in increments of $25.00 by choosing the quantity below.

$25.00 Quantity

Total

Debit or Credit Card
Credit Card Number	Security Code
Expiration Month	Expiration Year

Student Information - Student 1
First Name
Last Name
Date of Birth

MonthDayYear
Date
Grade (2026-2027)
School Attending (2026-2027)
Learning Needs, Medical Needs, Allergies
Small Group Request (6th - 10th Grade Only)
Baptism Received?
Where and When? (parish, city, state, year)
First Eucharist Received?
Where and When? (parish, city, state, year)
First Reconciliation Received?
Where and When? (parish, city, state, year)
Confirmation Received?
Where and When? (parish, city, state, year)
Student Information - Student 2
First Name
Last Name
Date of Birth

MonthDayYear
Date
Grade (2026-2027)
School Attending (2026-2027)
Learning Needs, Medical Needs, Allergies
Small Group Request (6th - 10th Grade Only)
Baptism Received?
Where and When? (parish, city, state, year)
First Eucharist Received?
Where and When? (parish, city, state, year)
First Reconciliation Received?
Where and When? (parish, city, state, year)
Confirmation Received?
Where and When? (parish, city, state, year)
Student Information - Student 3
First Name
Last Name
Date of Birth

MonthDayYear
Date
Grade (2026-2027)
School Attending (2026-2027)
Learning Needs, Medical Needs, Allergies
Small Group Request (6th - 10th Grade Only)
Baptism Received?
Where and When? (parish, city, state, year)
First Eucharist Received?
Where and When? (parish, city, state, year)
First Reconciliation Received?
Where and When? (parish, city, state, year)
Confirmation Received?
Where and When? (parish, city, state, year)
Student Information - Student 4
First Name
Last Name
Date of Birth

MonthDayYear
Date
Grade (2026-2027)
School Attending (2026-2027)
Learning Needs, Medical Needs, Allergies
Small Group Request (6th - 10th Grade Only)
Baptism Received?
Where and When? (parish, city, state, year)
First Eucharist Received?
Where and When? (parish, city, state, year)
First Reconciliation Received?
Where and When? (parish, city, state, year)
Confirmation Received?
Where and When? (parish, city, state, year)
Student Information - Student 5
First Name
Last Name
Date of Birth

MonthDayYear
Date
Grade (2026-2027)
School Attending (2026-2027)
Learning Needs, Medical Needs, Allergies
Small Group Request (6th - 10th Grade Only)
Baptism Received?
Where and When? (parish, city, state, year)
First Eucharist Received?
Where and When? (parish, city, state, year)
First Reconciliation Received?
Where and When? (parish, city, state, year)
Confirmation Received?
Where and When? (parish, city, state, year)
Miscellaneous Information
Emergency Contact Name for Family

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact Relationship
Photo/Media Release: I give permission for my child(ren)'s photo/video to be used in parish communications. We do not publish children's names. We usually use group pictures in our newsletters or bulletin.
Additional Comments or Notes
Should be Empty:

Family Information

Registration Payment

Registration Payment*

Student Information - Student 1

Student Information - Student 2

Student Information - Student 3

Student Information - Student 4

Student Information - Student 5

Miscellaneous Information

Registration Payment