Religious Education 2022-2023

If you’re having financial difficulties we can work on a plan that best suits your needs.

We are now accepting registrations online for the Religious Education Program (CCD) year 2022-2023. Visit our website http://stcolumbanusparish.org scroll to religious education, then click on the link below to start the registration process. Thank you

Primary Family Address

Are you a member of our Parish and use Family envelopes?

Yes No

If NO, What is you current parish?

Family Name

Address

Primary E-mail

This will be the main e-mail address we will use to communicate with your family.

Primary Phone

This will be the main phone number we will use to communicate with your family.

Number of Children

Number of Children you will be registering today

Number of Children

Number of Children you will be registering today

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Father / Guardian

Name

Deceased

Yes No

E-mail

Marital Status

Religion

Cell Phone

Mother / Guardian

Maiden Name

Name

Deceased

Yes No

E-mail

Marital Status

Religion

Cell Phone

Custody Information

Are there any custody issues we should be made aware of? If there is a custody agreement please send a copy to the Religious Education Department.

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Child 1

Name

Gender

Male Female

Date of Birth

Place of Birth

City & State

Religious Education Grade

Grade in Fall 2022

School Grade

School Grade in Fall 2022

School

School District

Individualized Education Program (IEP)

No Yes

Please list all pertinent medical/learning data so we can best meet the needs of your child. (Medical Conditions/Allergies - Prescribed Medications - Disability*/Learning Support Services)

Medical/Learning Data

*As defined by Individuals with Disabilities Education Act (IDEA), the term "child with a disability" means a child: "with mental retardation, hearing impairments (including deafness), speech or language impairments, visual impairments (including blindness), serious emotional disturbance, orthopedic impairments, autism, traumatic brain injury, other health impairments, or specific learning disabilities and who, by reason thereof, needs special education and related services."

Is your child a New or Returning Student to our program?

New Student Returning Student

Child 1 Sacraments

Previous Religious Education Experience

Please provide student's last grade completed and Parish Name / Address

If registering for first time your Child's Baptismal Certificate must be submitted to the office.

Date of Baptism

Church of Baptism

Church Name, City & State

Date of Reconciliation

Church of Reconciliation

Church Name, City & State

Date of First Communion

Church of First Communion

Church Name, City & State

Child 1 Session Choice

Sat: 9:00 - 10:30 AM, 1-5 grades Sun: 10:00 - 1:00 PM, 1-5 grades (including 12 Noon Mass) Mon: 7:00 - 8:30 PM, 6th, 7th & 8th grades only

Child 2

Name

Gender

Male Female

Date of Birth

Place of Birth

City & State

Religious Education Grade

Grade in Fall 2022

School Grade

School Grade in Fall 2022

School

School District

Individualized Education Program (IEP)

No Yes

Please list all pertinent medical/learning data so we can best meet the needs of your child. (Medical Conditions/Allergies - Prescribed Medications - Disability*/Learning Support Services)

Medical/Learning Data

*As defined by Individuals with Disabilities Education Act (IDEA), the term "child with a disability" means a child: "with mental retardation, hearing impairments (including deafness), speech or language impairments, visual impairments (including blindness), serious emotional disturbance, orthopedic impairments, autism, traumatic brain injury, other health impairments, or specific learning disabilities and who, by reason thereof, needs special education and related services."

Is your child a New or Returning Student to our program?

New Student Returning Student

Child 2 Sacraments

Previous Religious Education Experience

Please provide student's last grade completed and Parish Name / Address

If registering for first time your Child's Baptismal Certificate must be submitted to the office.

Date of Baptism

Church of Baptism

Church Name, City & State

Date of Reconciliation

Church of Reconciliation

Church Name, City & State

Date of First Communion

Church of First Communion

Church Name, City & State

Child 2 Session Choice

Sat: 9:00 - 10:30 AM, 1-5 grades Sun: 10:00 - 1:00 PM, 1-5 grades (including 12 Noon Mass) Mon: 7:00 - 8:30 PM, 6th, 7th & 8th grades only

Child 3

Name

Gender

Male Female

Date of Birth

Place of Birth

City & State

Religious Education Grade

Grade in Fall 2022

School Grade

School Grade in Fall 2022

School

School District

Individualized Education Program (IEP)

No Yes

Please list all pertinent medical/learning data so we can best meet the needs of your child. (Medical Conditions/Allergies - Prescribed Medications - Disability*/Learning Support Services)

Medical/Learning Data

*As defined by Individuals with Disabilities Education Act (IDEA), the term "child with a disability" means a child: "with mental retardation, hearing impairments (including deafness), speech or language impairments, visual impairments (including blindness), serious emotional disturbance, orthopedic impairments, autism, traumatic brain injury, other health impairments, or specific learning disabilities and who, by reason thereof, needs special education and related services."

Is your child a New or Returning Student to our program?

New Student Returning Student

Child 3 Sacraments

Previous Religious Education Experience

Please provide student's last grade completed and Parish Name / Address

If registering for first time your Child's Baptismal Certificate must be submitted to the office.

Date of Baptism

Church of Baptism

Church Name, City & State

Date of Reconciliation

Church of Reconciliation

Church Name, City & State

Date of First Communion

Church of First Communion

Church Name, City & State

Child 3 Session Choice

Sat: 9:00 - 10:30 AM, 1-5 grades Sun: 10:00 - 1:00 PM, 1-5 grades (including 12 Noon Mass) Mon: 7:00 - 8:30 PM, 6th, 7th & 8th grades only

Child 4

Name

Gender

Male Female

Date of Birth

Place of Birth

City & State

Religious Education Grade

Grade in Fall 2022

School Grade

School Grade in Fall 2022

School

School District

Individualized Education Program (IEP)

No Yes

Please list all pertinent medical/learning data so we can best meet the needs of your child. (Medical Conditions/Allergies - Prescribed Medications - Disability*/Learning Support Services)

Medical/Learning Data

*As defined by Individuals with Disabilities Education Act (IDEA), the term "child with a disability" means a child: "with mental retardation, hearing impairments (including deafness), speech or language impairments, visual impairments (including blindness), serious emotional disturbance, orthopedic impairments, autism, traumatic brain injury, other health impairments, or specific learning disabilities and who, by reason thereof, needs special education and related services."

Is your child a New or Returning Student to our program?

New Student Returning Student

Child 4 Sacraments

Previous Religious Education Experience

Please provide student's last grade completed and Parish Name / Address

If registering for first time your Child's Baptismal Certificate must be submitted to the office.

Date of Baptism

Church of Baptism

Church Name, City & State

Date of Reconciliation

Church of Reconciliation

Church Name, City & State

Date of First Communion

Church of First Communion

Church Name, City & State

Child 4 Session Choice

Sat: 9:00 - 10:30 AM, 1-5 grades Sun: 10:00 - 1:00 PM, 1-5 grades (including 12 Noon Mass) Mon: 7:00 - 8:30 PM, 6th, 7th & 8th grades only

Child 5

Name

Gender

Male Female

Date of Birth

Place of Birth

City & State

Religious Education Grade

Grade in Fall 2022

School Grade

School Grade in Fall 2022

School

School District

Individualized Education Program (IEP)

No Yes

Please list all pertinent medical/learning data so we can best meet the needs of your child. (Medical Conditions/Allergies - Prescribed Medications - Disability*/Learning Support Services)

Medical/Learning Data

*As defined by Individuals with Disabilities Education Act (IDEA), the term "child with a disability" means a child: "with mental retardation, hearing impairments (including deafness), speech or language impairments, visual impairments (including blindness), serious emotional disturbance, orthopedic impairments, autism, traumatic brain injury, other health impairments, or specific learning disabilities and who, by reason thereof, needs special education and related services."

Is your child a New or Returning Student to our program?

New Student Returning Student

Child 5 Sacraments

Previous Religious Education Experience

Please provide student's last grade completed and Parish Name / Address

If registering for first time your Child's Baptismal Certificate must be submitted to the office.

Date of Baptism

Church of Baptism

Church Name, City & State

Date of Reconciliation

Church of Reconciliation

Church Name, City & State

Date of First Communion

Church of First Communion

Church Name, City & State

Child 5 Session Choice

Sat: 9:00 - 10:30 AM, 1-5 grades Sun: 10:00 - 1:00 PM, 1-5 grades (including 12 Noon Mass) Mon: 7:00 - 8:30 PM, 6th, 7th & 8th grades only

Document Uploads

File Uploads

Add files

Drop files anywhere to add

Please upload any documents required by the office with this form. (Baptism, etc.)

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Emergency Contact

Emergency Contact Name

If we are unable to contact a parent in the event of an emergency, whom should we contact?

Relationship

Emergency Contact Phone

Doctor's Name

Doctor's Phone

Dismissal Directives

Check one

My child(ren) has/have permission to walk home from class. I/parents, will be picking up my/our child(ren) after class. (Fill in below) will be picking up my child(ren) after class.

Name of authorized person

Optional Phone

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Terms & Conditions

In the event of a Medical emergency and I’m not or the person listed as an emergency contact is unable to be reached, I hereby authorize such representative to call the physician above and follow his instructions or call Emergency Medical Services (EMS). If, unable to contact physician listed, the representative of the Parish Religious Education Program may take whatever action considered necessary.

I agree

I authorize St. Columbanus Religious Education Program to share pictures of my child(ren) on their Website.

Yes No

Total Choices

Additional Fee

Current Date

Total Normal

If you’re having financial difficulties we can work on a plan that best suits your needs.

We are now accepting registrations online for the Religious Education Program (CCD) year 2022-2023. Visit our website http://stcolumbanusparish.org scroll to religious education, then click on the link below to start the registration process. Thank you

Total Amount

Verification