Religious Education 2022-2023

Payment is required at the time of registration. Your child will not be assigned to a class without full payment.

If your family is experiencing financial difficulty and you would like to create a payment plan, please call for an appointment to register in person. Please do not delay in registering due to finances.

Primary Family Address

Are you a member of our Parish?

Yes No

If NO, What is you current parish?

Only registered members of our parish may attend PREP. If you would like become a member of our parish or if you only need to attend PREP at our parish, contact the PREP office 484-473-8344. Please note that permission from both pastors is required for you to take PREP at another parish and Sacraments are made at the home parish.

If YES, Please provide your ID #/Parish Envelope #?

That number is on your envelopes or in your Parish Giving account.

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 (Early Bird)

Number of Children you will be registering today

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Father / Guardian

Parent 1 Name

Deceased

Yes No

E-mail

Marital Status

Religion

Cell Phone

Does this person have permission to pick up the children?

Yes No

If not, please provide supporting paperwork for special circumstances when permission to pick up is revoked.

Mother / Guardian

Parent 2 Name

Deceased

Yes No

Maiden Name

E-mail

Marital Status

Religion

Cell Phone

Does this person have permission to pick up the children?

Yes No

If not, please provide supporting paperwork for special circumstances when permission to pick up is revoked.

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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Our PREP classes provide students in grades 1-7 with instruction in our Catholic faith while also assisting them in building a personal relationship with the Lord. Typically, the Sacraments of Reconciliation and Holy Communion are received in 2nd grade and Confirmation in 7th grade. In order to achieve this, a continuous religious education program is required. Children must attend 1st through 7th grade and have at least two years of religious education before a Sacrament can be received.

Child 1

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)

Please list:

*As defined by Individuals with Disabilities Education Act (IDEA), the term "child with a disability" means a child: "with an intellectual disability, 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

If a new student, please provide documentation of such including the students last grade completed, Parish contact information including email, verification of Sacraments received.

If registering for first time your Child's Baptismal Certificate must be submitted to the office. Please provide verification/certificate for each Sacrament received.

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

Monday 4:30-6:00 pm (After School) Tuesdays 4:30-6:00 pm (After School)

Child 2

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)

Please list:

*As defined by Individuals with Disabilities Education Act (IDEA), the term "child with a disability" means a child: "with an intellectual disability, 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

If a new student, please provide documentation of such including the students last grade completed, Parish contact information including email, verification of Sacraments received.

If registering for first time your Child's Baptismal Certificate must be submitted to the office. Please provide verification/certificate for each Sacrament received.

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

Monday 4:30-6:00 pm (After School) Tuesdays 4:30-6:00 pm (After School)

Child 3

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)

Please list:

*As defined by Individuals with Disabilities Education Act (IDEA), the term "child with a disability" means a child: "with an intellectual disability, 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

If a new student, please provide documentation of such including the students last grade completed, Parish contact information including email, verification of Sacraments received.

If registering for first time your Child's Baptismal Certificate must be submitted to the office. Please provide verification/certificate for each Sacrament received.

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

Monday 4:30-6:00 pm (After School) Tuesdays 4:30-6:00 pm (After School)

Child 4

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)

Please list:

*As defined by Individuals with Disabilities Education Act (IDEA), the term "child with a disability" means a child: "with an intellectual disability, 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

If a new student, please provide documentation of such including the students last grade completed, Parish contact information including email, verification of Sacraments received.

If registering for first time your Child's Baptismal Certificate must be submitted to the office. Please provide verification/certificate for each Sacrament received.

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

Monday 4:30-6:00 pm (After School) Tuesdays 4:30-6:00 pm (After School)

Child 5

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)

Please list:

*As defined by Individuals with Disabilities Education Act (IDEA), the term "child with a disability" means a child: "with an intellectual disability, 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

If a new student, please provide documentation of such including the students last grade completed, Parish contact information including email, verification of Sacraments received.

If registering for first time your Child's Baptismal Certificate must be submitted to the office. Please provide verification/certificate for each Sacrament received.

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

Monday 4:30-6:00 pm (After School) Tuesdays 4:30-6:00 pm (After School)

Middle & High School Youth Group

Which children are interested?

Child 1‎ Child 2‎ Child 3‎ Child 4‎ Child 5‎

Starts in 6th grade. Students are welcome to bring a friend! We meet once a month during the school year. Each meeting is a combination of social, spiritual & service. Fee: Free

Document Uploads

File Uploads

Add files

Drop files anywhere to add

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

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Immunizations

Are your child(ren)s immunizations up to date?

Yes No

If no, have they received an exemption from your current school district?

Yes No

Even if your child is exempt from immunizations, he/she may be excluded from school during an outbreak of the vaccine preventable disease.

If no, please explain

Emergency Contact

Emergency Contact Name 1

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

Relationship

Emergency Contact Phone 1

Emergency Contact Name 2

Relationship

Emergency Contact Phone 2

Student Pickup

People permitted to pick up my children

Please include their name, phone, and relationship to children

Parent Involvement

We strongly encourage and need parent participation in the classroom. Our hope is that PREP is faith formation for the whole family. Please list which ways you can contribute to our PREP studies.

Will you be volunteering?

Yes No

Volunteer Name

Volunteer Phone

Volunteer Interested in

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Terms & Conditions

I understand that in the case of injury or illness, every effort will be made to contact me in a medical emergency. In the event I cannot be reached, I give permission to parish staff to secure all proper and necessary treatment for my child(ren). I understand that no liability is assumed by the church or the Archdiocese for claims that may arise.

I agree

Parental Consent for Medical Care: In case of an emergency, I give permission for my child to receive emergency medical treatment and, if necessary, be transported to the nearest appropriate medical facility.

I agree

Please be aware that your child may be photographed or video recorded throughout the year for various uses on our parish websites, social media platforms, Masses, in our print media and publications as well as in Zoom lessons. By signing below, you grant us permission to take and use these photographs and videos.

I agree

Handbook: By registering your child, you agree to to abide to the teachings of the Catholic Church and the PREP handbook which will be given to each family at the start of PREP.

I agree

Sacramental Fees

Volunteer Discount

Additional Fee

3 Children Discount

Current Date

Total Normal

Payment is required at the time of registration. Your child will not be assigned to a class without full payment.

If your family is experiencing financial difficulty and you would like to create a payment plan, please call for an appointment to register in person. Please do not delay in registering due to finances.

Total Amount

Verification