Christ the King Religious Education Registration

- Religious Ed

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- Family Information
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Home Address REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Home Phone Number Maximum 20 characters Please enter a phone number.
- Father's Information
  
  Father's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Father's Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Father's Email REQUIRED Please fill out this field. Please enter an email address.
  
  Is the Father Catholic? REQUIRED Yes No Please fill out this field.
- Mother's Information
  
  Mother's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Maiden Name REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Mother's Email REQUIRED Please fill out this field. Please enter an email address.
  
  Is the Mother Catholic? REQUIRED Yes No Please fill out this field.
- Emergency Contact Information
  
  Emergency Contact Name REQUIRED Please fill out this field. Please enter valid data.
  
  Emergency Contact Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Student Information REQUIRED Please fill out this field.
  
  Student 1
  
  Student's Name Please enter valid data.
  
  Gender Male Female
  
  Is the student Catholic? Yes No
  
  Birth Date Please enter a date.
  
  Student's Grade Please enter valid data.
  
  Session Please enter valid data.
  
  Class Please enter valid data.
  
  Select the Sacraments the student has received Baptism Eucharist Reconciliation Prep Confirmation
  
  Provide dates for the sacraments if they are known.
  
  Special Needs (Medical, Learning, Disabilities, Physical Disabilities, etc.)
  
  Student 2
  
  Student's Name Please enter valid data.
  
  Gender Male Female
  
  Is the student Catholic? Yes No
  
  Birth Date Please enter a date.
  
  Student's Grade Please enter valid data.
  
  Session Please enter valid data.
  
  Class Please enter valid data.
  
  Select the Sacraments the student has received Baptism Eucharist Reconciliation Prep Confirmation
  
  Provide dates for the sacraments if they are known.
  
  Special Needs (Medical, Learning, Disabilities, Physical Disabilities, etc.)
  
  Student 3
  
  Student's Name Please enter valid data.
  
  Gender Male Female
  
  Is the student Catholic? Yes No
  
  Birth Date Please enter a date.
  
  Student's Grade Please enter valid data.
  
  Session Please enter valid data.
  
  Class Please enter valid data.
  
  Select the Sacraments the student has received Baptism Eucharist Reconciliation Prep Confirmation
  
  Provide dates for the sacraments if they are known.
  
  Special Needs (Medical, Learning, Disabilities, Physical Disabilities, etc.)
  
  Student 4
  
  Student's Name Please enter valid data.
  
  Gender Male Female
  
  Is the student Catholic? Yes No
  
  Birth Date Please enter a date.
  
  Student's Grade Please enter valid data.
  
  Session Please enter valid data.
  
  Class Please enter valid data.
  
  Select the Sacraments the student has received Baptism Eucharist Reconciliation Prep Confirmation
  
  Provide dates for the sacraments if they are known.
  
  Special Needs (Medical, Learning, Disabilities, Physical Disabilities, etc.)
  
  Student 5
  
  Student's Name Please enter valid data.
  
  Gender Male Female
  
  Is the student Catholic? Yes No
  
  Birth Date Please enter a date.
  
  Student's Grade Please enter valid data.
  
  Session Please enter valid data.
  
  Class Please enter valid data.
  
  Select the Sacraments the student has received Baptism Eucharist Reconciliation Prep Confirmation
  
  Provide dates for the sacraments if they are known.
  
  Special Needs (Medical, Learning, Disabilities, Physical Disabilities, etc.)
  
  Student 6
  
  Student's Name Please enter valid data.
  
  Gender Male Female
  
  Is the student Catholic? Yes No
  
  Birth Date Please enter a date.
  
  Student's Grade Please enter valid data.
  
  Session Please enter valid data.
  
  Class Please enter valid data.
  
  Select the Sacraments the student has received Baptism Eucharist Reconciliation Prep Confirmation
  
  Provide dates for the sacraments if they are known.
  
  Special Needs (Medical, Learning, Disabilities, Physical Disabilities, etc.)
  
  Student 7
  
  Student's Name Please enter valid data.
  
  Gender Male Female
  
  Is the student Catholic? Yes No
  
  Birth Date Please enter a date.
  
  Student's Grade Please enter valid data.
  
  Session Please enter valid data.
  
  Class Please enter valid data.
  
  Select the Sacraments the student has received Baptism Eucharist Reconciliation Prep Confirmation
  
  Provide dates for the sacraments if they are known.
  
  Special Needs (Medical, Learning, Disabilities, Physical Disabilities, etc.)
  
  Student 8
  
  Student's Name Please enter valid data.
  
  Gender Male Female
  
  Is the student Catholic? Yes No
  
  Birth Date Please enter a date.
  
  Student's Grade Please enter valid data.
  
  Session Please enter valid data.
  
  Class Please enter valid data.
  
  Select the Sacraments the student has received Baptism Eucharist Reconciliation Prep Confirmation
  
  Provide dates for the sacraments if they are known.
  
  Special Needs (Medical, Learning, Disabilities, Physical Disabilities, etc.)
  
  Student 9
  
  Student's Name Please enter valid data.
  
  Gender Male Female
  
  Is the student Catholic? Yes No
  
  Birth Date Please enter a date.
  
  Student's Grade Please enter valid data.
  
  Session Please enter valid data.
  
  Class Please enter valid data.
  
  Select the Sacraments the student has received Baptism Eucharist Reconciliation Prep Confirmation
  
  Provide dates for the sacraments if they are known.
  
  Special Needs (Medical, Learning, Disabilities, Physical Disabilities, etc.)
  
  Student 10
  
  Student's Name Please enter valid data.
  
  Gender Male Female
  
  Is the student Catholic? Yes No
  
  Birth Date Please enter a date.
  
  Student's Grade Please enter valid data.
  
  Session Please enter valid data.
  
  Class Please enter valid data.
  
  Select the Sacraments the student has received Baptism Eucharist Reconciliation Prep Confirmation
  
  Provide dates for the sacraments if they are known.
  
  Special Needs (Medical, Learning, Disabilities, Physical Disabilities, etc.)
- Note
  If any of your children were baptized outside of this parish, and you have not already supplied us with a copy of each child's baptismal record, you will need to supply a copy for our files.
- Tuition REQUIRED 25.0 – $25 per child 40.0 – $40 per family Please fill out this field.
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Christ the King Religious Education Registration

Note