Saint Gregory the Great Religious Formation Registration Form
2015-2016 School Year for Grades Pk-10
~We Need Original Registration Forms For Each Student~
Registration Fees: Grades: PK-1 & 3-8: $45.00 per student
First Communion Registration Fee for Grade 2: $75.00 per student
Confirmation Program Grade 9 & 10: $75.00 per student
Retreats for Grade 9 & 10 will be announced
Please Write Check Out to St. Gregory the Great Church
Gentle Reminder: All Students MUST BE REGISTERED BEFORE Class Begins. If changes need to be
made, please call the office at 884-1666 ext. 3. Thank You!
SCHEDULE: PLEASE CIRCLE GRADE AND DAY OF CLASS
Summer Only for 1 week
12:30pm-5:30pm
Confirmation 1( Gr. 9) Boot Camp
June 25-July 1, 2015
Sunday
9:50am-10:50am
1
2
3
4
5
6
7
8
9
Sunday
11:00am-During Mass
Pk & K (Ages 4-5)
Monday
3:45pm-5:00pm
1
2
3
4
5
6
7
8
Tuesday
3:45pm-5:00pm
1
2
3
4
5
6
7
8
Wednesday
3:45pm-5:00pm
1
2
3
4
5
6
7
8
Wednesday Evening
6:30pm-7:40pm
7
8
9
10
10
DID YOUR CHILD ATTEND: Religious Education at another Parish in 2014/2015 School Year? Yes
No
~If Yes, Name of Parish:
_______
STUDENT INFORMATION: Please Print Clearly STUDENT GRADE (Entering in 2015-2016) _____________
Student’s Full Name:
_________________
School: _________________________________________ Date of Birth:
M or F
Address: _________________________________________________________________________________
City/ Town: ___________________________ State: _____________ Zip Code: ________________________
This is the Address that Will be Used for Mailings.
Allergies: Type ________________________________________________________________________________
Instructions: __________________________________________________________________________________
IEP: Yes_____
No______ Special Needs and Classroom Considerations: ______________________________
~PLEASE FILL BOTH SIDES OF THIS FORM~
Saint Gregory the Great Religious Formation Registration Form
2015-2016 School Year for Grades Pk-10
~We Need Original Registration Forms For Each Student~
Sacramental Information of Student:
NEW STUDENTS TO THE PARISH OR ENTERING THE PROGRAM FOR THE FIRST TIME NEED TO
PROVIDE:

PHOTOCOPY OF BAPTISMAL CERTIFICATE

PHOTOCOPY OF FIRST EUCHARIST CERTIFICATE IF APPLICABLE
_____ Yes, my child was BAPTIZED at St. Gregory the Great Church: Month
_____
No, my child was BAPTIZED at Different Church:
Year
Please Provide Copy of Baptismal Certificate
If Baptismal Certificate is Not Readily Available -Please Send Registration Form Ahead and Send in Certificate as Soon as
Possible. Thank You!
PARENT/GUARDIAN INFORMATION: Please Print Clearly
Mother’s Name____________________________________________
Mother’s Home Phone
Religion
Maiden Name_______________________
Mother’s Cell Phone _______________________________
_______________________________________________________________________________
Mother’s E-mail Address
Father’s Name ________________________________________________________________________________
Father’s Home Phone:
Religion
Father’s Cell Phone ______________________________
_______________________________________________________________________________
Father’s E-mail Address
In Case of Emergency:
If we are unable to contact you, please indicate the person we should contact:
_____
Name
__________
Relationship to child
Phone
PHOTO-ELECTRONIC MEDIA RELEASE- Please Circle Yes or No
 YES I give permission for my son/daughter

NO I do not give permission for my son/daughter (I understand that It is my child’s responsibility to remove
himself/herself from the photographic situation.
_______________________________________________________ to be photographed or videotaped at or by the St.
Gregory the Great Parish Program of Religious Formation. I understand that the photo may be published in the newspaper,
a magazine, the parish website, or other publication. The video may be used for informational or educational purposes
regarding the programs or curriculum at St. Gregory the Great Parish Program of Religious Formation.
Parent Signature _______________________________________________ Date ___________________________
Office Use Only:
Registered Parishioner Yes______ No______ Check #______________________ Amt._________________
Cash Amt._________________
Date________________
Initials_________________