BVM-Wynnewood RE Registration

Parish Religious Education Program Registration Form 2026/2027 Presentation B. V. M. Parish

For first time registrations, please send one copy of each child's Baptismal Certificate.

Rows	Child's Full Name (First, Middle, & Last)	Sex M/F	Date of Birth	Grade Level	Name and phone number of Day School	Baptism Date & Parish	1st Penance Date/Parish	1st Communion Date/Parish
1
2
3

Family Name:
Home Phone #:
Format: (000) 000-0000.
Address

Street Address

CityState / Province

Postal / Zip Code
Parent Email:
example@example.com
Father's Name:
Work or Cell Phone #:
Format: (000) 000-0000.
Religion
Mother's Name:
Work or Cell Phone #:
Format: (000) 000-0000.
Religion
Are there any custody/legal issues? (If yes, please provide a complete copy of the latest court order.)
*Name of person responsible for Religious Education if not a Parent/Guardian
Relationship
*Parent/guardian must provide a signed, dated letter of permission to the DRE which is to be kept on file and updated annually.
Please note that the parish bulletin is also posted on parish website. You will also have option of submitting picture for Sacrament Bulletin Board in Church.
VOLUNTEER (Please Check if interested)
Signature
Date

MonthDayYear
Date
Relationship to Child(ren)
EMERGENCY CONTACT INFORMATION:

If we are unable to reach you, whom should we contact?
Name:

First NameLast Name
Relationship:
Phone Number (home)
Format: (000) 000-0000.
Phone Number (cell)
Format: (000) 000-0000.
CONSENT FOR MEDICAL CARE:
I give permission that, in my absence, my children whose names appear on page 1 of this registration form, may receive emergency medical care for injuries and all situations that should occur while participating in the Religious Education Program programs and activities at Presentation B. V. M. Parish.
Signed (Parent/Legal Guardian) :
Date:

MonthDayYear
Date
MEDICAL/LEARNING DATA

If any of the following apply to your child, please list his/her name and give details in the appropriate spaces.

Rows	Child's Name	Medical Conditions/Allergies	Prescribed Medications	Disability* / Learning Support Services	Individualized Education Program IEP (Yes/No)
1
2

* As defined by Individuals with Disabilities Education Act (IDEA), the term "child with a disability" means a child with: and intellectual disability, a hearing impairment (including deafness), a speech or language impairment, a visual impairment (including blindness), a serious emotional disturbance, an orthopedic impairment, autism, traumatic brain injury, another health impairment, a specific learning disability, deaf-blindness, or multiple disabilities, and who, by reason thereof, needs special education and related services.
**Immunization: Are your children' s vaccinations up to date?
(This does not refer to COVID; rather child &adolescent immunizations.)
**Immunization: Even if your child is exempt from immunizations, he/she may be excluded from school during outbreak of the vaccine preventable disease
If no, has he/she received an exemption from your current school district?
Is there other information about your child that should be communicated?
If anyone other than a parent /guardian or Emergency Contact has permission to pick up your child from PREP, we need their information and parent consent in writing (every year). A child cannot be picked up early unless we have note from parent. Also, if your child is permitted to walk home after class, we need you to fill out the Walker Release form (every year) which can be downloaded from our website www.presbvm.org
Registration Fee is $100. per child. Please register by August 19, 2026 to avoid a late fee of $50.00
Date
Relationship to Child(ren)
Signature
Should be Empty:

Parish Religious Education Program Registration Form 2026/2027 Presentation B. V. M. Parish

EMERGENCY CONTACT INFORMATION:

CONSENT FOR MEDICAL CARE:

MEDICAL/LEARNING DATA