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  • St. Augustine Church
    Religious Education Registration 2021-2022
  • Please Circle One REQUIRED New Family Re-Registration Please fill out this field.
  • Family Last Name Please enter valid data.
  • Contact Information:
    • Mailing Address REQUIRED Please fill out this field. Please enter valid data.
    • Father's First Name Please enter valid data.
    • Mother's First Name Please enter valid data.
    • Mother's Maiden Name Please enter valid data.
    • Home Phone Number Maximum 20 characters Please enter a phone number.
    • Cell Phone Maximum 20 characters Please enter a phone number.
    • Email REQUIRED Please fill out this field. Please enter an email address.
  • • Number of Children Registering REQUIRED
      Fill in for each child
      Please fill out this field.
    • Child 1
      • Full Name of Child Please enter valid data.
      • Date of Birth REQUIRED Please fill out this field. Please enter a date.
      • Grade Please enter valid data.
      • Church, Town of Baptism REQUIRED Please fill out this field. Please enter valid data.
      • Baptism Date REQUIRED Please fill out this field. Please enter a date.
      • Baptism Certificate on File Yes No Don't know
      • First Penance Church and Date (mm/yyyy) Please enter valid data.
      • First Communion Church and Date (mm/yyyy) Please enter valid data.
      • Allergies

        Enter all allergies including food, medications, environmental
      • Other Considerations
    • Child 2
      • Full Name of Child Please enter valid data.
      • Date of Birth REQUIRED Please fill out this field. Please enter a date.
      • Grade Please enter valid data.
      • Church, Town of Baptism REQUIRED Please fill out this field. Please enter valid data.
      • Baptism Date REQUIRED Please fill out this field. Please enter a date.
      • Baptism Certificate on File Yes No Don't know
      • First Penance Church and Date (mm/yyyy) Please enter valid data.
      • First Communion Church and Date (mm/yyyy) Please enter valid data.
      • Allergies

        Enter all allergies including food, medications, environmental
      • Other Considerations
    • Child 3
      • Full Name of Child Please enter valid data.
      • Date of Birth REQUIRED Please fill out this field. Please enter a date.
      • Grade Please enter valid data.
      • Church, Town of Baptism REQUIRED Please fill out this field. Please enter valid data.
      • Baptism Date REQUIRED Please fill out this field. Please enter a date.
      • Baptism Certificate on File Yes No Don't know
      • First Penance Church and Date (mm/yyyy) Please enter valid data.
      • First Communion Church and Date (mm/yyyy) Please enter valid data.
      • Allergies

        Enter all allergies including food, medications, environmental
      • Other Considerations
    • Child 4
      • Full Name of Child Please enter valid data.
      • Date of Birth REQUIRED Please fill out this field. Please enter a date.
      • Grade Please enter valid data.
      • Church, Town of Baptism REQUIRED Please fill out this field. Please enter valid data.
      • Baptism Date REQUIRED Please fill out this field. Please enter a date.
      • Baptism Certificate on File Yes No Don't know
      • First Penance Church and Date (mm/yyyy) Please enter valid data.
      • First Communion Church and Date (mm/yyyy) Please enter valid data.
      • Allergies

        Enter all allergies including food, medications, environmental
      • Other Considerations
    • Child 5
      • Full Name of Child Please enter valid data.
      • Date of Birth REQUIRED Please fill out this field. Please enter a date.
      • Grade Please enter valid data.
      • Church, Town of Baptism REQUIRED Please fill out this field. Please enter valid data.
      • Baptism Date REQUIRED Please fill out this field. Please enter a date.
      • Baptism Certificate on File Yes No Don't know
      • First Penance Church and Date (mm/yyyy) Please enter valid data.
      • First Communion Church and Date (mm/yyyy) Please enter valid data.
      • Allergies

        Enter all allergies including food, medications, environmental
      • Other Considerations
  • I give permission for my child(ren) to be included in photographs/videos used in Religious Education Please select this field.
  • 2020-2021 Rates for Registrations:
    1 Child - $75
    2 Children - $90
    3 or more - $115 (family maximum)
  • Amount Due REQUIRED $0.00 – (Select One) $75.00 – 1 Child $90.00 – 2 children $115.00 – Family Max Please fill out this field.

  Total:

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