Fee Paid _____________
Sacred Heart Church Religious Education
353 Main Street, Highland Falls, NY 10928 845-446-2674
Registration – 2015/2016
Last Name: ______________________________Home Phone:________________________Parent’s e-mail ___________________@_________
Address_____________________________________________ Box #_______________ Highland Falls ________ Ft. Montgomery_________
Father: __________________________________________
Mother (include maiden)______________________________________
Father’s Religion:__________________________________
Mother’s Religion: ___________________________________________
Father’s Work Phone:_______________________________
Mother’s Work Phone:________________________________________
Father’s Cell Phone:_________________________________
Mother’s Cell Phone:_________________________________________
Emergency Contact:_____________________________ Phone:______________________________Cell Phone___________________________
Doctor’s Name:____________________________________________________Phone:_______________________________________________
Child’s Full Name (as on Baptismal Certificate):______________________________________ Birth date:___________ Registration for Grade _____
Baptismal Date:_____________________________
Church:_________________________________________________________________
First Penance Date:__________________________
Church:_________________________________________________________________
First Communion Date:_______________________
Church:_________________________________________________________________
Does your child have allergies:____________________________________________________________________________________________
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Child’s Full Name (as on Baptismal Certificate):______________________________________ Birth date:___________ Registration for Grade _____
Baptismal Date:_____________________________
Church:_________________________________________________________________
First Penance Date:__________________________
Church:_________________________________________________________________
First Communion Date:_______________________
Church:_________________________________________________________________
Does your child have allergies:____________________________________________________________________________________________
*********************************************************************************************************************
Child’s Full Name (as on Baptismal Certificate):______________________________________ Birth date:___________ Registration for Grade _____
Baptismal Date:_____________________________
Church:_________________________________________________________________
First Penance Date:__________________________
Church:_________________________________________________________________
First Communion Date:_______________________
Church:_________________________________________________________________
Does your child have allergies:____________________________________________________________________________________________
*********************************************************************************************************************
Child’s Full Name (as on Baptismal Certificate):______________________________________ Birth date:___________ Registration for Grade _____
Baptismal Date:_____________________________
Church:_________________________________________________________________
First Penance Date:__________________________
Church:_________________________________________________________________
First Communion Date:_______________________
Church:_________________________________________________________________
Does your child have allergies:_________________________________________________________________________________
(over)
Fees for the 2015-16 Year
Tuition and fees are due at time of registration. Cash or checks only please. (Payable to: Sacred Heart)
Registration Tuition:
$105 for one child
$140 for two children
$195 for three or more children
Sacramental Fees:
$40 for First Communion (Second Grade)
$75 for Confirmation (Eighth Grade)
If it is necessary that my child be taken from the Sacred Heart school building where catechetical sessions are held, I designate the following
person(s) as having the authority to do so in my place.
Name:_________________________________________________________ Phone_______________________________________
Address:____________________________________________________Relationship______________________________________
Parent/Guardian Signature _______________________________________________________Date ___________________________
Parent/Guardian
Photo Release Form
I hereby consent to and authorize the use and reproduction, in print or electronic format, by Sacred Heart Church or anyone authorized by Sacred
Heart Church, of any and all photographs of my child taken at Sacred Heart events for any publicity purpose, without compensation. Sacred Heart
Church reserves the right to use these photographs in any of its print or electronic publications. All images – are owned by Sacred Heart Church.
I hereby warrant that I have read and understood the terms of this release.
Parent/Guardian Signature _______________________________________________________Date ___________________________
Please consider participating in our Religious Education Program and serving the children enrolled in it:
I/We would like to offer assistance in the following areas:
______Catechist
_____Teacher’s aide
_____ Substitute Teacher
_____Babysitting for catechist’s child on Sunday or Wednesday
_____Office help (mailings)
_____ Vacation Bible School (July)