2026-2027 Religious Education Registration Form

2026-2027 Religious Education Registration Form
Child 1 Information
Child's Full Name

First NameMiddle NameLast Name
M/F
Attended Religious Education Before
If YES where and what year(s)?
School Attending
Grade
Date of Birth

MonthDayYear
Date
Church & Location of Baptism (If applicable)
*If the child was not baptized in St. Gertrude Church, please provide a copy of the baptismal certificate. If the child made First Communion in St.Gertrude more than 3 years ago and is not baptized in St. Gertrude, you need to provide the baptismal certificate once again.
Date of Baptism

MonthDayYear
Date
Church & Location of First Holy Communion (If applicable)
Date of First Communion

MonthDayYear
Date
So that we can best serve your child, please list any known conditions that we should be made aware of (i.e. Learning Disabilities, Allergies, Medications taken, Medical, Physical, Emotional, Behavioral, etc.)
Child 2's Information
Child's Full Name (Last Name, First Name & Middle Name)

First NameMiddle NameLast Name
M/F
Attended Rel. Ed. Before
If YES where and what year(s)?
School Attending
Grade
DOB

MonthDayYear
Date
Church & Location of Baptism (If applicable)
*If the child was not baptized in St. Gertrude Church, please provide a copy of the baptismal certificate. If the child made First Communion in St..Gertrude more than 3 years ago and is not baptized in St. Gertrude, you need to provide the baptismal certificate once again.
Date of Baptism

MonthDayYear
Church & Location of 1st Holy Communion (If applicable)
Date of First Communion

MonthDayYear
Date
So that we can best serve your child, please list any known conditions that we should be made aware of (i.e. Learning Disabilities, Allergies, Medications taken, Medical, Physical, Emotional, Behavioral, etc.)
Child 3's Information
Child's Full Name (Last Name, First Name & Middle Name)

First NameMiddle NameLast Name
M/F
Attended Rel. Ed. Before
If YES where and what year(s)?
School Attending
Grade
DOB

MonthDayYear
Date
Church & Location of Baptism (If applicable)
*If the child was not baptized in St. Gertrude Church, please provide a copy of the baptismal certificate. If the child made First Communion in St..Gertrude more than 3 years ago and is not baptized in St. Gertrude, you need to provide the baptismal certificate once again.
Date of Baptism

MonthDayYear
Date
Church & Location of 1st Holy Communion (If applicable)
Date of First Communion

MonthDayYear
Date
So that we can best serve your child, please list any known conditions that we should be made aware of (i.e. Learning Disabilities, Allergies, Medications taken, Medical, Physical, Emotional, Behavioral, etc.)
Parent, Address, and Emergency Information
Parent 1 Name & Last Name

First NameLast Name
Parent 1 Phone
Please enter a valid phone number.Format: (000) 000-0000.
Parent 1 E-mail
example@example.com
Parent 2 Name & Last Name

First NameLast Name
Parent 2 Phone
Please enter a valid phone number.Format: (000) 000-0000.
Parent 2 E-mail
example@example.com
Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
City
State
Zip
Emergency Contact Name

First NameLast Name
Emergency Contact Relation to Parents
Emergency Contact Phone #
Please enter a valid phone number.Format: (000) 000-0000.
Tuition Note
Payment Details

Tuition is $230 for the first (or only) child and $40 for each additional child from the same family.
GiveCentral/Online Payment
Check
Parent/Legal Guardian (Print)
Parent/Legal Guardian Signature

I request that the above-named participant(s) be allowed to attend church-related activities with St. Gertrude Catholic Church. I , the parent /guardian of the above minor(s), do hereby give permission for him/her to attend Religious Education /Sacramental Preparation classes and to be treated for a medical emergency in my absence while participating in the Religious Education program. The adult supervisor may act as an agent in my absence. In case of accident, I do not hold the Archdiocese of Chicago, the Parish (St. Gertrude), its staff, or any catechists/chaperones responsible for accident or injury. I understand that all costs incurred will be my (parent or Legal guardian) responsibility. I also understand that if my student breaks any of the program rules, the proper authorities will be contacted, and I (the parent or legal guardian) will be notified of all actions taken and/or to immediately pick up my child from the premises.
Date (Consent Signed)

MonthDayYear
Date
Are you a Parishioner of St. Gertrude?
Should be Empty:

2026-2027 Religious Education Registration Form

Child 1 Information

Child 2's Information

Child 3's Information

Parent, Address, and Emergency Information

Payment Details