OUR LADY OF LORETTO RELIGIOUS EDUCATION
Registration for Grades 1-12
2014 - 2015
Return to the Religious Education Office, 1806 Novato Blvd., Novato, CA 94947 by August 15, 2014
Child(ren’s) LAST Name:
Home Phone:
Address:
Zip:
Father’s Full Name:
Work Phone:
E-Mail:
Cell Phone:
Mother’s Full Name:
Work Phone:
Mother’s Maiden Name: (Required)
E-Mail:
Cell Phone:
Emergency Contact Name:
Phone:
Child’s First Name
Gender
Grade:
School:
Has child
Has child
Date of
Fall 2014 Fall 2014
been
made First
Birth
Baptized: Communion:
Yes or No
Yes or No
Is your child making his/her First Reconciliation/First Communion/or Confirmation this year? If your
child was not baptized at Our Lady of Loretto, you must provide a copy of his/her Baptismal Certificate.
If you do not have one, you may obtain one by calling or writing the Church of Baptism and requesting a copy.
Please submit it to Our Lady of Loretto Religious Education Office. Certificates need to be received no later
than November 1, 2014.
Church of Baptism
Address – Street, City, State/Country, Zip
Date of Baptism
Child 1
Child 2
See reverse for schedule of classes for the 2014-2015 program.
We encourage you to submit the tuition and fees in a timely manner. Please contact the Religious
Education Office if you need tuition/fee assistance. Please make checks payable to Our Lady of Loretto
RE – 1806 Novato Blvd., Novato, CA 94947
Basic Tuition
One Child
$175
Two Children
$225
Three or More
$250
Sacramental Fee (paid for First Reconciliation,
Per Child
$75
First Communion, or Confirmation year only)
Credit for other child in Religious Education/OLL School
Per Family
($50)
Total Tuition and Fees:
OFFICE USE ONLY:
Tuition Due:
Pd:
Date:
Pd:
Date:
Pd:
Date:
Fees Due:
Pd:
Date:
Pd:
Date:
Pd:
Date:
______________________________________________________
Signature
Please complete reverse side
_________________________
Date
OUR LADY OF LORETTO RELIGIOUS EDUCATION
2014 – 2015 Program
SCHEDULE OF CLASSES
Grade 1 and Grades 3-6 meet on Mondays or Tuesdays from 4-5pm
in the Catholic School. Please indicate your preference Mon or Tues here ____________________________
Grade 2 and all students in final preparation for First Communion
meet on Tuesdays in the Catholic School from 4-5pm. Tuesday is the only option for all First Communicants
below Grade 7.
Grades 7 and 8 meet on Monday evenings from 7-8:30pm in the Convent. This is PreConfirmation Preparation and is required in order to enter the final year of Confirmation.
Grades 9-12 meet on Thursday evenings from 7pm-8:30pm in the Convent.
TRANSPORTATION
Please indicate below if someone other than the parent or guardian (signed below) will be responsible for picking
up your child/children after the Religious Education Classes:
Name:____________________________________________ Phone:_______________________
No skateboards are allowed as a means of transportation. Will your child be allowed to walk or ride a bike to and
from class:
Yes____________
No______________
EMERGENCY MEDICAL RELEASE
The following is a release to provide Medical Care in the case of an emergency, such as an earthquake, or if your
child becomes ill or is injured. Your child will not be left alone during an emergency situation. You will be
contacted as soon as possible.
Family Physician:
Phone:
Address:
City/Zip
Medical Plan:
Plan No:
If you do not want medical care given to your child, please state the
reason:
HOLD HARMLESS AGREEMENT
I/We agree that in the event my/our child is injured as a result of his/her participation in religious education
activities, including transportation to and from these activities, whether or not caused by negligence of the
parish/school Religious Education/Youth Ministry program or any of its agents or employees, recourse for the
payment of resulting hospital, medical or related costs and expense will be first paid for and covered by any
accident, hospital or medical insurance, or any other available benefit or mine/ours.
Parent/Guardians Signature: _______________________________________________________
Telephone No.: __________________________________________________________________
Date: __________________________________________________________________________