Registration Form

The maximum number of form submissions has been reached. This form is currently not available.

Family Name REQUIRED Please fill out this field. Please enter valid data.
Father's Name REQUIRED Please fill out this field. Please enter valid data.
Mother's Maiden REQUIRED Please fill out this field. Please enter valid data.
Address REQUIRED Please fill out this field. Please enter valid data.
Email Address REQUIRED Please fill out this field. Please enter an email address.
Home Phone REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
Father's Cell/Work REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
Mother's Cell/Work REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
Are Both Parents Catholic? REQUIRED Yes No Please fill out this field.
Registration Fee
If you don't want to pay now, you can click the "PAY LATER" button at the end of the form
35.0 – First Child 55.0 – Child in a Sacramental Year (Communion/Confirmation) 25.0 – Second Child 25.0 – Third Child 25.0 – Fourth Child 25.0 – Fifth Child
Emergency
- Contact Name REQUIRED Please fill out this field. Please enter valid data.
- Contact Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
Student #1
- Child's Name REQUIRED Please fill out this field. Please enter valid data.
- Gender REQUIRED Male Female Please fill out this field.
- Birth Date REQUIRED Please fill out this field. Please enter valid data.
- Grade Level REQUIRED Please fill out this field. Please enter valid data.
- Catholic REQUIRED Yes No Please fill out this field.
- Sacrament Details
  Check what the child has received or prepared for.
  Baptism Eucharist Reconciliation Prep Confirmation
- Sacrament Dates and Places
  Share Dates and Places where child received/prepared for above sacraments
- Special Needs (Medical, Learning Disabilities, Physical Disabilities, etc.)
Student #2
- Child's Name Please enter valid data.
- Gender Male Female
- Birth Date Please enter valid data.
- Grade Level Please enter valid data.
- Catholic Yes No
- Sacrament Details
  Check what the child has received or prepared for.
  Baptism Eucharist Reconciliation Prep Confirmation
- Sacrament Dates and Places
  Share Dates and Places where child received/prepared for above sacraments
- Special Needs (Medical, Learning Disabilities, Physical Disabilities, etc.)
Student #3
- Child's Name Please enter valid data.
- Gender Male Female
- Birth Date Please enter valid data.
- Class Please enter valid data.
- Catholic Yes No
- Sacrament Details
  Check what the child has received or prepared for.
  Baptism Eucharist Reconciliation Prep Confirmation
- Sacrament Dates and Places
  Share Dates and Places where child received/prepared for above sacraments
- Special Needs (Medical, Learning Disabilities, Physical Disabilities, etc.)
Student #4
- Child's Name Please enter valid data.
- Gender Male Female
- Birth Date Please enter valid data.
- Grade Level Please enter valid data.
- Catholic Yes No
- Sacrament Details
  Check what the child has received or prepared for.
  Baptism Eucharist Reconciliation Prep Confirmation
- Sacrament Dates and Places
  Share Dates and Places where child received/prepared for above sacraments
- Special Needs (Medical, Learning Disabilities, Physical Disabilities, etc.)
Student #5
- Child's Name Please enter valid data.
- Gender Male Female
- Birth Date Please enter valid data.
- Grade Level Please enter valid data.
- Catholic Yes No
- Sacrament Details
  Check what the child has received or prepared for.
  Baptism Eucharist Reconciliation Prep Confirmation
- Sacrament Dates and Places
  Share Dates and Places where child received/prepared for above sacraments
- Special Needs (Medical, Learning Disabilities, Physical Disabilities, etc.)
If you don't want to pay now, you can click the "PAY LATER" button to pay when your child comes for the first class.

Total:

Submit

Pay Now

Pay Later

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.