Religious Education Registration Form Director of Religious Education
Check here if there are changes from last year's RE Form:
Family Last Name
Father's Name
Father's Cell
Father's E-Mail
Mother's Name
Mother's Maiden Name
Mother's Cell
Mother's E-Mail
Custodial Parent, if different from above
Home Phone
Home Address
ZIP
Parish Member of
Emergency Contact Name
Emergency Contact Number
I give permission for my child(ren)'s pictures to be on Holy Rosary's website/Facebook/posters/flyers/bulletins
Parent Name (This serves as your electronic signature)
Schedule RE Classes:
Fees Religious Education Student Fee:
This Section For Office Use Only Tuition Due
Tuition Paid
Date
Payment
Check #
Credit Card #
Cash Amount
Student Information Baptismal Certificates are REQUIRED at Registration for ALL 2nd & 11th Grade Students. If your child was Baptized at Holy Rosary, please check 'Yes'. If not, please contact the Parish your child was baptized at and bring a copy of the Baptismal Certificate to the Registration Meeting or drop it off at the parish office.
Child's Name:
Sex:
Male
Female
Birth Date
Grade:
Child's Cell Phone Number
I give my permission for you to contact my child with information about the Holy Rosary RE Program/Teen Destiny
Dates of Sacraments Already Made Baptism
Penance
Holy Communion
Place of Baptism
Special Needs: Learning/Physical Disabilities
Child's Name
Sex
Male
Female
Birthdate
Grade
Child's Cell Phone Number
I give my permission for you to contact my child with information about the Holy Rosary RE Program/Teen Destiny
Dates of Sacraments Already Made Baptism
Penance
Holy Communion
Place of Baptism
Special Needs: Learning/Physical Disabilities
Child's Name
Sex:
Male
Female
Birthdate
Grade
Child's Cell Phone Number
I give my permission for you to contact my child with information about the Holy Rosary RE Program/Teen Destiny
Dates of Sacraments Already Made Baptism
Penance
Holy Communion
Place of Baptism
Special Needs: Learning/Physical Disabilities
Child's Name
Sex:
Male
Female
Birthdate
Grade
Child's Cell Phone Number
I give my permission for you to contact my child with information about the Holy Rosary RE Program/Teen Destiny
Dates of Sacraments Already Made Baptism
Penance
Holy Communion
Place of Baptism
Special Needs: Learning/Physical Disabilities
Our Religious Education Director will verify this information at the Registration Meeting.
Archdiocese of Milwaukee: Release of Information Photography & Video Consent Form I hereby consent that any still or electronic image and/or audio recording, in which I or my child appear, may be used by Our Lady of the Holy Rosary of Pompeii parish/school and/or by the Archdiocese of Milwaukee. I understand that these materials are being used for promotion of Our Lady of the Holy Rosary of Pompeii parish/school and/or the Archdiocese of Milwaukee. The images and/or recordings may be used to support recruitment, fundraising, evangelization and other communication efforts.
Parent/Legal Guardian Name
Date Signed
Name(s) of Child(ren)
Home Phone
Cell Phone
Address
City
State
ZIP
Signature of Parent/Legal Guardian (By entering my full name, I attest that this constitutes my legal electronic signature on this form.)
