Religious Education Registration

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Family and Contact Information
Father's Information
First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.
Phone Number REQUIRED Please fill out this field. Please enter a phone number.
Father's Religion REQUIRED Please fill out this field.
Mother's Information
First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.
Phone Number REQUIRED Please fill out this field. Please enter a phone number.
Mother's Religion REQUIRED Please fill out this field.
Family Information
Child(ren) currently reside with: REQUIRED Please fill out this field.
If your child(ren) currently reside with someone other than the child's parent(s), please indicate below Please enter valid data.
If there are any non-custodial parents, please indicate below
Parent Email Address REQUIRED Please fill out this field. Please enter an email address.
Additional Email Address Please enter an email address.
Address REQUIRED Please fill out this field. Please enter valid data.
City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.
Child(ren)'s Information
First Child
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Child's Birthdate REQUIRED Please fill out this field. Please enter a date.
- Child's Grade REQUIRED Please fill out this field.
- Child's current school REQUIRED Please fill out this field. Please enter valid data.
- Religious education option for First Child REQUIRED Homeschool (grade based, $25 per student) Online Class with Catechist (Spirit of Truth, $25 per student) Family Model without Online Support (Family of Faith, $35, per family) Family Model with Online Support (Family of Faith, $35 per family) Please fill out this field.
Second Child
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- Child's Birthdate Please enter a date.
- Child's Grade
- Child's current school Please enter valid data.
- Religious education option for Second Child Homeschool (grade based, $25 per student) Online Class with Catechist (Spirit of Truth, $25 per student) Family Model without Online Support (Family of Faith, $35, per family) Family Model with Online Support (Family of Faith, $35 per family)
Third Child
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- Child's Grade
- Child's Birthdate Please enter a date.
- Child's current school Please enter valid data.
- Religious education option for Third Child Homeschool (grade based, $25 per student) Online Class with Catechist (Spirit of Truth, $25 per student) Family Model without Online Support (Family of Faith, $35, per family) Family Model with Online Support (Family of Faith, $35 per family)
Fourth Child
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- Child's Birthdate Please enter a date.
- Child's Grade
- Child's current school Please enter valid data.
- Religious education option for Fourth Child Homeschool (grade based, $25 per student) Online Class with Catechist (Spirit of Truth, $25 per student) Family Model without Online Support (Family of Faith, $35, per family) Family Model with Online Support (Family of Faith, $35 per family)
- Policy Acknowledgement
  
  We have read the St. Paul’s Religious Education Handbook. We agree to support and abide by the policies set forth in the handbook.
  
  Please discuss all policies with all children.
  I Agree Please select this field.
- Safe Pick Up Policy
  
  When religious education classes and events are held on campus, it is recommended that parents of students pick up their children inside the safety of the building rather than have them meet you outside. The parish cannot be responsible for those children not escorted by an adult family member.
  I Agree Please select this field.
- Release of Liability
  
  In consideration of St. Paul the Apostle Catholic Church accepting my child’s registration in the Religious Education Program, I/we release, hold harmless and discharge St. Paul the Apostle Catholic Church and the Diocese of Harrisburg, their officers, trustees, employees, agents, and catechists of and from any and all liability, claim, damage, cost or expense, except in the case of willful/intentional harm or gross negligence and waive any such claims agains any such person or organization in connection with the Chruch of the Diocese of Harrisburg.
  I Agree Please select this field.
- Please let us know if your child has any particular learning needs, food allergies, or simply if you need to include any additional comments.

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Religious Education Registration

Family and Contact Information

Father's Information

Mother's Information

Family Information

Child(ren)'s Information