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2020-2021 Registration

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Saint Joseph Religious Education Progam On-line Registration for 2020-2021 School Year
The maximum number of form submissions has been reached. This form is currently not available.
- Are you new to our program? REQUIRED
  If you are new to the program, we will need a copy of your child’s Baptismal Certificate.
  Yes No Please fill out this field.
- Are you current members of Saint Joseph Parish? REQUIRED Yes No Please fill out this field.
- If yes, please enter your parish ID number (found on church envelopes): Please enter valid data.
- If no, which parish are you a member Please enter valid data.
- Number of Child(ren) you are registering REQUIRED Please fill out this field.
  
  Child 1
  
  Name of child REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Child's Place of Birth: City and State REQUIRED Please fill out this field. Please enter valid data.
  
  Male or Female REQUIRED Please fill out this field.
  
  Child's Home Mailing Address REQUIRED Please fill out this field. Please enter valid data.
  
  Child's REP Grade for 2020-2021 REQUIRED Please fill out this field.
  
  Which session? REQUIRED Sunday, 9:30 AM (Preschool-Kindergarten) Monday, 4:00 PM - 5:30 PM (Grades 1-8) Monday, 6:30 PM - 8:00 PM (Grades 1-8) Wednesday 5:00 PM - 7:00 PM (Grades 9-12) Please fill out this field.
  
  School District REQUIRED Please fill out this field.
  
  Name of School Attending REQUIRED Please fill out this field.
  
  Sacraments Received REQUIRED Baptism Reconciliation First Holy Communion Confirmation Please fill out this field.
  
  Church of Baptism REQUIRED Please fill out this field. Please enter valid data.
  
  Church of Baptism City and State REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Allergic Reactions to medications, food, insects, etc. REQUIRED Please fill out this field. Please enter valid data.
  
  Child's current prescriptions and/or medications: (name, dose, frequency) REQUIRED Please fill out this field. Please enter valid data.
  
  Any special needs or other requests?
  
  Child's Medical/Psychological/etc. Condition(s) REQUIRED Please fill out this field. Please enter valid data.
  
  Physician's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Physician's Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Dentist's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Dentist's Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Mother's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Marital Status REQUIRED Single Married Widowed Separated Divorced Not married, living together Please fill out this field.
  
  Mother's Religion REQUIRED Catholic Christian Jewish None Other Please fill out this field.
  
  Mother's Email REQUIRED Please fill out this field. Please enter an email address.
  
  Mother's Mailing Address REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Mother's Work Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Mother's Home Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Father's First Name-Middle Name-Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Father's Marital Status REQUIRED Single Married Widowed Separated Divorced Not married, living together Please fill out this field.
  
  Father's Religion REQUIRED Catholic Christian Jewish None Other Please fill out this field.
  
  Father's Email REQUIRED Please fill out this field. Please enter an email address.
  
  Father's Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Father's Work Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Father's Home Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Full Name of Mother or Guardian Emergency Contact REQUIRED Please fill out this field. Please enter valid data.
  
  Mother/Guardian Emergency Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Full Name of Father or Guardian Emergency Contact REQUIRED Please fill out this field. Please enter valid data.
  
  Full Name of Father or Guardian Emergency Contact REQUIRED Please fill out this field. Please enter a phone number.
  
  Full Name of Primary Local Emergency Contact if Mother/Father/Guardian cannot be reached REQUIRED Please fill out this field. Please enter valid data.
  
  Primary Local Emergency Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Full Name of Secondary Local Emergency Contact if Mother/Father/Guardian cannot be reached REQUIRED Please fill out this field. Please enter valid data.
  
  Secondary Local Emergency Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Emergency Medical Authorization given by: REQUIRED Please fill out this field. Please enter valid data.
  
  In case of accident or serious illness, I request the Saint Joseph Religious Education office contact me or my designate. If this cannot be done, I authorize the Religious Education office to call the physician or dentist listed on this form and to follow his/her instructions. If the physician or dentist named cannot be reached, the Religious Education office may seek medical services that seem necessary. I realize the Religious Education office does not assume responsibility for the payment of medical expenses.
  I Agree Please select this field.
  
  Authorization REQUIRED Please fill out this field.
  
  Name of Legal Guardian agreeing to these statements: REQUIRED Please fill out this field. Please enter valid data.
  
  CATHOLIC RELIGIOUS EDUCATION PROGRAM PARENT(S) MEMORANDUM OF UNDERSTANDING
  As the parent(s) of a student in a Catholic Religious Education Program, I understand and affirm the following:
  
  The primary purpose of a Catholic Religious Education is to form students in the values of Jesus Christ and the teachings of the Catholic Church.
  
  Catholic Religious Education Programs are distinctive religious education establishments operated as programs of the Catholic Church; they are administered and supported by the sponsoring parish, and the diocese.
  
  Catholic Religious Education Programs are a collaborative faith effort between the Religious Education Program, the parents, and the students.
  
  While academic excellence and involvement in other extracurricular activities (i.e., sports, clubs, etc.) are important, committing to the schedule of the Religious Education Program is the fundamental priority.
  
  The Religious Education Program and its Coordinator have the responsibility to ensure that Catholic values and moral integrity permeate every facet of the program’s life and activities.
  
  In all questions involving faith, morals, faith teaching, and Church law, the final determination rests with the diocesan bishop. As a parent/guardian desiring to enroll my child in a Catholic Religious Education Program, I accept this memorandum of understanding. I pledge support for the Catholic identity and mission of this program, and by enrolling my child I commit myself to uphold all the principles and policies that govern a Catholic Religious Education Program.
  
  Saint Joseph Religious Education Attendance Policy
  (First Through Eighth Grade)
  
  Students will now be required to attend at least 80 percent of ALL Religious Education classes. This means that for the 2020-2021 Religious Education year, students will be allowed a total of FIVE (5) “ABSENCES” without penalty, and therefore no verification (such as a doctor’s note) is needed.
  
  Students who are more than 15 minutes late, or leave more than 15 minutes early will be marked as “LATE.” Three occurrences of being “LATE” will equal ONE “ABSENCE.”
  
  If a student exceeds the total number of allowable “ABSENCES”, they will have to repeat that grade level.
  
  ONLY IN GENUINE EXTENUATING CIRCUMSTANCES (such as a serious illness or a death in the immediate family) will exceptions be made to this attendance policy. ANY exceptions that are made will be at the discretion of both the Pastor and the Coordinator of Religious Education.
  
  I have read the above policies of the Saint Joseph Religious Education Program. I understand the terms of these policies and agree to abide by them. I acknowledge that failure to comply with these policies could lead to corrective action up to and including dismissal from the program.
  I Agree Please select this field.
  
  Student Media Release:
  We at Saint Joseph Parish are proud of the many great accomplishments that happen within the Religious Education Program, and we want to be able to share these great moments with you! By signing this release, you grant us permission to photograph and/or video your child or children during their Religious Education classes, and to use those photos and videos on our parish website, Facebook page, print publications, and future Religious Education promotion. The majority of the photos and videos taken are in either small or large groups, and we DO NOT publish students’ names in order to protect their privacy. Saint Joseph Parish respects either decision regarding this matter.
  
  Permission Statements REQUIRED I GIVE permission to have my child or children photographed or videoed. I DO NOT GIVE permission to have my child or children photographed or videoed. Please fill out this field.
  
  Electronic Signature of Legal Guardian Completing this form REQUIRED Please fill out this field. Please enter valid data.
  
  Child 6
  
  Name of child REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Child's Place of Birth: City and State REQUIRED Please fill out this field. Please enter valid data.
  
  Male or Female REQUIRED Please fill out this field.
  
  Child's Home Mailing Address REQUIRED Please fill out this field. Please enter valid data.
  
  Child's REP Grade for 2020-2021 REQUIRED Please fill out this field.
  
  Which session? REQUIRED Sunday, 9:30 AM (Preschool-Kindergarten) Monday, 4:00 PM - 5:30 PM (Grades 1-8) Monday, 6:30 PM - 8:00 PM (Grades 1-8) Wednesday 5:00 PM - 7:00 PM (Grades 9-12) Please fill out this field.
  
  School District REQUIRED Please fill out this field.
  
  Sacraments Received REQUIRED Baptism Reconciliation First Holy Communion Confirmation Please fill out this field.
  
  Church of Baptism REQUIRED Please fill out this field. Please enter valid data.
  
  Church of Baptism City and State REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Allergic Reactions to medications, food, insects, etc. REQUIRED Please fill out this field. Please enter valid data.
  
  Child's current prescriptions and/or medications: (name, dose, frequency) REQUIRED Please fill out this field. Please enter valid data.
  
  Any special needs or other requests?
  
  Child's Medical/Psychological/etc. Condition(s) REQUIRED Please fill out this field. Please enter valid data.
  
  Physician's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Physician's Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Dentist's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Dentist's Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Mother's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Marital Status REQUIRED Single Married Widowed Separated Divorced Not married, living together Please fill out this field.
  
  Mother's Religion REQUIRED Catholic Christian Jewish None Other Please fill out this field.
  
  Mother's Email REQUIRED Please fill out this field. Please enter an email address.
  
  Mother's Mailing Address REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Mother's Work Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Mother's Home Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Father's First Name-Middle Name-Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Father's Marital Status REQUIRED Single Married Widowed Separated Divorced Not married, living together Please fill out this field.
  
  Father's Religion REQUIRED Catholic Christian Jewish None Other Please fill out this field.
  
  Father's Email REQUIRED Please fill out this field. Please enter an email address.
  
  Father's Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Father's Work Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Father's Home Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Full Name of Mother or Guardian Emergency Contact REQUIRED Please fill out this field. Please enter valid data.
  
  Mother/Guardian Emergency Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Full Name of Father or Guardian Emergency Contact REQUIRED Please fill out this field. Please enter valid data.
  
  Full Name of Father or Guardian Emergency Contact REQUIRED Please fill out this field. Please enter a phone number.
  
  Full Name of Primary Local Emergency Contact if Mother/Father/Guardian cannot be reached REQUIRED Please fill out this field. Please enter valid data.
  
  Primary Local Emergency Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Full Name of Secondary Local Emergency Contact if Mother/Father/Guardian cannot be reached REQUIRED Please fill out this field. Please enter valid data.
  
  Secondary Local Emergency Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Emergency Medical Authorization given by: REQUIRED Please fill out this field. Please enter valid data.
  
  In case of accident or serious illness, I request the Saint Joseph Religious Education office contact me or my designate. If this cannot be done, I authorize the Religious Education office to call the physician or dentist listed on this form and to follow his/her instructions. If the physician or dentist named cannot be reached, the Religious Education office may seek medical services that seem necessary. I realize the Religious Education office does not assume responsibility for the payment of medical expenses.
  I Agree Please select this field.
  
  Authorization REQUIRED Please fill out this field.
  
  Name of Legal Guardian agreeing to these statements: REQUIRED Please fill out this field. Please enter valid data.
  
  CATHOLIC RELIGIOUS EDUCATION PROGRAM PARENT(S) MEMORANDUM OF UNDERSTANDING
  As the parent(s) of a student in a Catholic Religious Education Program, I understand and affirm the following:
  
  The primary purpose of a Catholic Religious Education is to form students in the values of Jesus Christ and the teachings of the Catholic Church.
  
  Catholic Religious Education Programs are distinctive religious education establishments operated as programs of the Catholic Church; they are administered and supported by the sponsoring parish, and the diocese.
  
  Catholic Religious Education Programs are a collaborative faith effort between the Religious Education Program, the parents, and the students.
  
  While academic excellence and involvement in other extracurricular activities (i.e., sports, clubs, etc.) are important, committing to the schedule of the Religious Education Program is the fundamental priority.
  
  The Religious Education Program and its Coordinator have the responsibility to ensure that Catholic values and moral integrity permeate every facet of the program’s life and activities.
  
  In all questions involving faith, morals, faith teaching, and Church law, the final determination rests with the diocesan bishop. As a parent/guardian desiring to enroll my child in a Catholic Religious Education Program, I accept this memorandum of understanding. I pledge support for the Catholic identity and mission of this program, and by enrolling my child I commit myself to uphold all the principles and policies that govern a Catholic Religious Education Program.
  
  Saint Joseph Religious Education Attendance Policy
  (First Through Eighth Grade)
  
  Students will now be required to attend at least 80 percent of ALL Religious Education classes. This means that for the 2020-2021 Religious Education year, students will be allowed a total of FIVE (5) “ABSENCES” without penalty, and therefore no verification (such as a doctor’s note) is needed.
  
  Students who are more than 15 minutes late, or leave more than 15 minutes early will be marked as “LATE.” Three occurrences of being “LATE” will equal ONE “ABSENCE.”
  
  If a student exceeds the total number of allowable “ABSENCES”, they will have to repeat that grade level.
  
  ONLY IN GENUINE EXTENUATING CIRCUMSTANCES (such as a serious illness or a death in the immediate family) will exceptions be made to this attendance policy. ANY exceptions that are made will be at the discretion of both the Pastor and the Coordinator of Religious Education.
  
  I have read the above policies of the Saint Joseph Religious Education Program. I understand the terms of these policies and agree to abide by them. I acknowledge that failure to comply with these policies could lead to corrective action up to and including dismissal from the program.
  I Agree Please select this field.
  
  Student Media Release:
  We at Saint Joseph Parish are proud of the many great accomplishments that happen within the Religious Education Program, and we want to be able to share these great moments with you! By signing this release, you grant us permission to photograph and/or video your child or children during their Religious Education classes, and to use those photos and videos on our parish website, Facebook page, print publications, and future Religious Education promotion. The majority of the photos and videos taken are in either small or large groups, and we DO NOT publish students’ names in order to protect their privacy. Saint Joseph Parish respects either decision regarding this matter.
  
  Permission Statements REQUIRED I GIVE permission to have my child or children photographed or videoed. I DO NOT GIVE permission to have my child or children photographed or videoed. Please fill out this field.
  
  Electronic Signature of Legal Guardian Completing this form REQUIRED Please fill out this field. Please enter valid data.
  
  Name of School Attending REQUIRED Please fill out this field.
  
  Child 7
  
  Name of child REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Child's Place of Birth: City and State REQUIRED Please fill out this field. Please enter valid data.
  
  Male or Female REQUIRED Please fill out this field.
  
  Child's Home Mailing Address REQUIRED Please fill out this field. Please enter valid data.
  
  Child's REP Grade for 2020-2021 REQUIRED Please fill out this field.
  
  Which session? REQUIRED Sunday, 9:30 AM (Preschool-Kindergarten) Monday, 4:00 PM - 5:30 PM (Grades 1-8) Monday, 6:30 PM - 8:00 PM (Grades 1-8) Wednesday 5:00 PM - 7:00 PM (Grades 9-12) Please fill out this field.
  
  School District REQUIRED Please fill out this field.
  
  Name of School Attending REQUIRED Please fill out this field.
  
  Sacraments Received REQUIRED Baptism Reconciliation First Holy Communion Confirmation Please fill out this field.
  
  Church of Baptism REQUIRED Please fill out this field. Please enter valid data.
  
  Church of Baptism City and State REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Allergic Reactions to medications, food, insects, etc. REQUIRED Please fill out this field. Please enter valid data.
  
  Child's current prescriptions and/or medications: (name, dose, frequency) REQUIRED Please fill out this field. Please enter valid data.
  
  Any special needs or other requests?
  
  Child's Medical/Psychological/etc. Condition(s) REQUIRED Please fill out this field. Please enter valid data.
  
  Physician's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Physician's Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Dentist's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Dentist's Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Mother's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Marital Status REQUIRED Single Married Widowed Separated Divorced Not married, living together Please fill out this field.
  
  Mother's Religion REQUIRED Catholic Christian Jewish None Other Please fill out this field.
  
  Mother's Email REQUIRED Please fill out this field. Please enter an email address.
  
  Mother's Mailing Address REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Mother's Work Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Mother's Home Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Father's First Name-Middle Name-Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Father's Marital Status REQUIRED Single Married Widowed Separated Divorced Not married, living together Please fill out this field.
  
  Father's Religion REQUIRED Catholic Christian Jewish None Other Please fill out this field.
  
  Father's Email REQUIRED Please fill out this field. Please enter an email address.
  
  Father's Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Father's Work Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Father's Home Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Full Name of Mother or Guardian Emergency Contact REQUIRED Please fill out this field. Please enter valid data.
  
  Mother/Guardian Emergency Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Full Name of Father or Guardian Emergency Contact REQUIRED Please fill out this field. Please enter valid data.
  
  Full Name of Father or Guardian Emergency Contact REQUIRED Please fill out this field. Please enter a phone number.
  
  Full Name of Primary Local Emergency Contact if Mother/Father/Guardian cannot be reached REQUIRED Please fill out this field. Please enter valid data.
  
  Primary Local Emergency Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Full Name of Secondary Local Emergency Contact if Mother/Father/Guardian cannot be reached REQUIRED Please fill out this field. Please enter valid data.
  
  Secondary Local Emergency Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Emergency Medical Authorization given by: REQUIRED Please fill out this field. Please enter valid data.
  
  In case of accident or serious illness, I request the Saint Joseph Religious Education office contact me or my designate. If this cannot be done, I authorize the Religious Education office to call the physician or dentist listed on this form and to follow his/her instructions. If the physician or dentist named cannot be reached, the Religious Education office may seek medical services that seem necessary. I realize the Religious Education office does not assume responsibility for the payment of medical expenses.
  I Agree Please select this field.
  
  Authorization REQUIRED Please fill out this field.
  
  Name of Legal Guardian agreeing to these statements: REQUIRED Please fill out this field. Please enter valid data.
  
  CATHOLIC RELIGIOUS EDUCATION PROGRAM PARENT(S) MEMORANDUM OF UNDERSTANDING
  As the parent(s) of a student in a Catholic Religious Education Program, I understand and affirm the following:
  
  The primary purpose of a Catholic Religious Education is to form students in the values of Jesus Christ and the teachings of the Catholic Church.
  
  Catholic Religious Education Programs are distinctive religious education establishments operated as programs of the Catholic Church; they are administered and supported by the sponsoring parish, and the diocese.
  
  Catholic Religious Education Programs are a collaborative faith effort between the Religious Education Program, the parents, and the students.
  
  While academic excellence and involvement in other extracurricular activities (i.e., sports, clubs, etc.) are important, committing to the schedule of the Religious Education Program is the fundamental priority.
  
  The Religious Education Program and its Coordinator have the responsibility to ensure that Catholic values and moral integrity permeate every facet of the program’s life and activities.
  
  In all questions involving faith, morals, faith teaching, and Church law, the final determination rests with the diocesan bishop. As a parent/guardian desiring to enroll my child in a Catholic Religious Education Program, I accept this memorandum of understanding. I pledge support for the Catholic identity and mission of this program, and by enrolling my child I commit myself to uphold all the principles and policies that govern a Catholic Religious Education Program.
  
  Saint Joseph Religious Education Attendance Policy
  (First Through Eighth Grade)
  
  Students will now be required to attend at least 80 percent of ALL Religious Education classes. This means that for the 2020-2021 Religious Education year, students will be allowed a total of FIVE (5) “ABSENCES” without penalty, and therefore no verification (such as a doctor’s note) is needed.
  
  Students who are more than 15 minutes late, or leave more than 15 minutes early will be marked as “LATE.” Three occurrences of being “LATE” will equal ONE “ABSENCE.”
  
  If a student exceeds the total number of allowable “ABSENCES”, they will have to repeat that grade level.
  
  ONLY IN GENUINE EXTENUATING CIRCUMSTANCES (such as a serious illness or a death in the immediate family) will exceptions be made to this attendance policy. ANY exceptions that are made will be at the discretion of both the Pastor and the Coordinator of Religious Education.
  
  I have read the above policies of the Saint Joseph Religious Education Program. I understand the terms of these policies and agree to abide by them. I acknowledge that failure to comply with these policies could lead to corrective action up to and including dismissal from the program.
  I Agree Please select this field.
  
  Student Media Release:
  We at Saint Joseph Parish are proud of the many great accomplishments that happen within the Religious Education Program, and we want to be able to share these great moments with you! By signing this release, you grant us permission to photograph and/or video your child or children during their Religious Education classes, and to use those photos and videos on our parish website, Facebook page, print publications, and future Religious Education promotion. The majority of the photos and videos taken are in either small or large groups, and we DO NOT publish students’ names in order to protect their privacy. Saint Joseph Parish respects either decision regarding this matter.
  
  Permission Statements REQUIRED I GIVE permission to have my child or children photographed or videoed. I DO NOT GIVE permission to have my child or children photographed or videoed. Please fill out this field.
  
  Electronic Signature of Legal Guardian Completing this form REQUIRED Please fill out this field. Please enter valid data.
  
  Child 2
  
  Name of child REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Child's Place of Birth: City and State REQUIRED Please fill out this field. Please enter valid data.
  
  Male or Female REQUIRED Please fill out this field.
  
  Child's Home Mailing Address REQUIRED Please fill out this field. Please enter valid data.
  
  Child's REP Grade for 2020-2021 REQUIRED Please fill out this field.
  
  Which session? REQUIRED Sunday, 9:30 AM (Preschool-Kindergarten) Monday, 4:00 PM - 5:30 PM (Grades 1-8) Monday, 6:30 PM - 8:00 PM (Grades 1-8) Wednesday 5:00 PM - 7:00 PM (Grades 9-12) Please fill out this field.
  
  School District REQUIRED Please fill out this field.
  
  Name of School Attending REQUIRED Please fill out this field.
  
  Sacraments Received REQUIRED Baptism Reconciliation First Holy Communion Confirmation Please fill out this field.
  
  Church of Baptism REQUIRED Please fill out this field. Please enter valid data.
  
  Church of Baptism City and State REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Allergic Reactions to medications, food, insects, etc. REQUIRED Please fill out this field. Please enter valid data.
  
  Child's current prescriptions and/or medications: (name, dose, frequency) REQUIRED Please fill out this field. Please enter valid data.
  
  Any special needs or other requests?
  
  Child's Medical/Psychological/etc. Condition(s) REQUIRED Please fill out this field. Please enter valid data.
  
  Physician's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Physician's Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Dentist's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Dentist's Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Mother's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Marital Status REQUIRED Single Married Widowed Separated Divorced Not married, living together Please fill out this field.
  
  Mother's Religion REQUIRED Catholic Christian Jewish None Other Please fill out this field.
  
  Mother's Email REQUIRED Please fill out this field. Please enter an email address.
  
  Mother's Mailing Address REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Mother's Work Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Mother's Home Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Father's First Name-Middle Name-Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Father's Marital Status REQUIRED Single Married Widowed Separated Divorced Not married, living together Please fill out this field.
  
  Father's Religion REQUIRED Catholic Christian Jewish None Other Please fill out this field.
  
  Father's Email REQUIRED Please fill out this field. Please enter an email address.
  
  Father's Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Father's Work Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Father's Home Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Full Name of Mother or Guardian Emergency Contact REQUIRED Please fill out this field. Please enter valid data.
  
  Mother/Guardian Emergency Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Full Name of Father or Guardian Emergency Contact REQUIRED Please fill out this field. Please enter valid data.
  
  Full Name of Father or Guardian Emergency Contact REQUIRED Please fill out this field. Please enter a phone number.
  
  Full Name of Primary Local Emergency Contact if Mother/Father/Guardian cannot be reached REQUIRED Please fill out this field. Please enter valid data.
  
  Primary Local Emergency Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Full Name of Secondary Local Emergency Contact if Mother/Father/Guardian cannot be reached REQUIRED Please fill out this field. Please enter valid data.
  
  Secondary Local Emergency Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Emergency Medical Authorization given by: REQUIRED Please fill out this field. Please enter valid data.
  
  In case of accident or serious illness, I request the Saint Joseph Religious Education office contact me or my designate. If this cannot be done, I authorize the Religious Education office to call the physician or dentist listed on this form and to follow his/her instructions. If the physician or dentist named cannot be reached, the Religious Education office may seek medical services that seem necessary. I realize the Religious Education office does not assume responsibility for the payment of medical expenses.
  I Agree Please select this field.
  
  Authorization REQUIRED Please fill out this field.
  
  Name of Legal Guardian agreeing to these statements: REQUIRED Please fill out this field. Please enter valid data.
  
  CATHOLIC RELIGIOUS EDUCATION PROGRAM PARENT(S) MEMORANDUM OF UNDERSTANDING
  As the parent(s) of a student in a Catholic Religious Education Program, I understand and affirm the following:
  
  The primary purpose of a Catholic Religious Education is to form students in the values of Jesus Christ and the teachings of the Catholic Church.
  
  Catholic Religious Education Programs are distinctive religious education establishments operated as programs of the Catholic Church; they are administered and supported by the sponsoring parish, and the diocese.
  
  Catholic Religious Education Programs are a collaborative faith effort between the Religious Education Program, the parents, and the students.
  
  While academic excellence and involvement in other extracurricular activities (i.e., sports, clubs, etc.) are important, committing to the schedule of the Religious Education Program is the fundamental priority.
  
  The Religious Education Program and its Coordinator have the responsibility to ensure that Catholic values and moral integrity permeate every facet of the program’s life and activities.
  
  In all questions involving faith, morals, faith teaching, and Church law, the final determination rests with the diocesan bishop. As a parent/guardian desiring to enroll my child in a Catholic Religious Education Program, I accept this memorandum of understanding. I pledge support for the Catholic identity and mission of this program, and by enrolling my child I commit myself to uphold all the principles and policies that govern a Catholic Religious Education Program.
  
  Saint Joseph Religious Education Attendance Policy
  (First Through Eighth Grade)
  
  Students will now be required to attend at least 80 percent of ALL Religious Education classes. This means that for the 2020-2021 Religious Education year, students will be allowed a total of FIVE (5) “ABSENCES” without penalty, and therefore no verification (such as a doctor’s note) is needed.
  
  Students who are more than 15 minutes late, or leave more than 15 minutes early will be marked as “LATE.” Three occurrences of being “LATE” will equal ONE “ABSENCE.”
  
  If a student exceeds the total number of allowable “ABSENCES”, they will have to repeat that grade level.
  
  ONLY IN GENUINE EXTENUATING CIRCUMSTANCES (such as a serious illness or a death in the immediate family) will exceptions be made to this attendance policy. ANY exceptions that are made will be at the discretion of both the Pastor and the Coordinator of Religious Education.
  
  I have read the above policies of the Saint Joseph Religious Education Program. I understand the terms of these policies and agree to abide by them. I acknowledge that failure to comply with these policies could lead to corrective action up to and including dismissal from the program.
  I Agree Please select this field.
  
  Student Media Release:
  We at Saint Joseph Parish are proud of the many great accomplishments that happen within the Religious Education Program, and we want to be able to share these great moments with you! By signing this release, you grant us permission to photograph and/or video your child or children during their Religious Education classes, and to use those photos and videos on our parish website, Facebook page, print publications, and future Religious Education promotion. The majority of the photos and videos taken are in either small or large groups, and we DO NOT publish students’ names in order to protect their privacy. Saint Joseph Parish respects either decision regarding this matter.
  
  Permission Statements REQUIRED I GIVE permission to have my child or children photographed or videoed. I DO NOT GIVE permission to have my child or children photographed or videoed. Please fill out this field.
  
  Electronic Signature of Legal Guardian Completing this form REQUIRED Please fill out this field. Please enter valid data.
  
  Child 3
  
  Name of child REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Child's Place of Birth: City and State REQUIRED Please fill out this field. Please enter valid data.
  
  Male or Female REQUIRED Please fill out this field.
  
  Child's Home Mailing Address REQUIRED Please fill out this field. Please enter valid data.
  
  Child's REP Grade for 2020-2021 REQUIRED Please fill out this field.
  
  Which session? REQUIRED Sunday, 9:30 AM (Preschool-Kindergarten) Monday, 4:00 PM - 5:30 PM (Grades 1-8) Monday, 6:30 PM - 8:00 PM (Grades 1-8) Wednesday 5:00 PM - 7:00 PM (Grades 9-12) Please fill out this field.
  
  School District REQUIRED Please fill out this field.
  
  Name of School Attending REQUIRED Please fill out this field.
  
  Sacraments Received REQUIRED Baptism Reconciliation First Holy Communion Confirmation Please fill out this field.
  
  Church of Baptism REQUIRED Please fill out this field. Please enter valid data.
  
  Church of Baptism City and State REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Allergic Reactions to medications, food, insects, etc. REQUIRED Please fill out this field. Please enter valid data.
  
  Child's current prescriptions and/or medications: (name, dose, frequency) REQUIRED Please fill out this field. Please enter valid data.
  
  Any special needs or other requests?
  
  Child's Medical/Psychological/etc. Condition(s) REQUIRED Please fill out this field. Please enter valid data.
  
  Physician's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Physician's Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Dentist's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Dentist's Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Mother's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Marital Status REQUIRED Single Married Widowed Separated Divorced Not married, living together Please fill out this field.
  
  Mother's Religion REQUIRED Catholic Christian Jewish None Other Please fill out this field.
  
  Mother's Email REQUIRED Please fill out this field. Please enter an email address.
  
  Mother's Mailing Address REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Mother's Work Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Mother's Home Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Father's First Name-Middle Name-Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Father's Marital Status REQUIRED Single Married Widowed Separated Divorced Not married, living together Please fill out this field.
  
  Father's Religion REQUIRED Catholic Christian Jewish None Other Please fill out this field.
  
  Father's Email REQUIRED Please fill out this field. Please enter an email address.
  
  Father's Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Father's Work Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Father's Home Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Full Name of Mother or Guardian Emergency Contact REQUIRED Please fill out this field. Please enter valid data.
  
  Mother/Guardian Emergency Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Full Name of Father or Guardian Emergency Contact REQUIRED Please fill out this field. Please enter valid data.
  
  Full Name of Father or Guardian Emergency Contact REQUIRED Please fill out this field. Please enter a phone number.
  
  Full Name of Primary Local Emergency Contact if Mother/Father/Guardian cannot be reached REQUIRED Please fill out this field. Please enter valid data.
  
  Primary Local Emergency Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Full Name of Secondary Local Emergency Contact if Mother/Father/Guardian cannot be reached REQUIRED Please fill out this field. Please enter valid data.
  
  Secondary Local Emergency Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Emergency Medical Authorization given by: REQUIRED Please fill out this field. Please enter valid data.
  
  In case of accident or serious illness, I request the Saint Joseph Religious Education office contact me or my designate. If this cannot be done, I authorize the Religious Education office to call the physician or dentist listed on this form and to follow his/her instructions. If the physician or dentist named cannot be reached, the Religious Education office may seek medical services that seem necessary. I realize the Religious Education office does not assume responsibility for the payment of medical expenses.
  I Agree Please select this field.
  
  Authorization REQUIRED Please fill out this field.
  
  Name of Legal Guardian agreeing to these statements: REQUIRED Please fill out this field. Please enter valid data.
  
  CATHOLIC RELIGIOUS EDUCATION PROGRAM PARENT(S) MEMORANDUM OF UNDERSTANDING
  As the parent(s) of a student in a Catholic Religious Education Program, I understand and affirm the following:
  
  The primary purpose of a Catholic Religious Education is to form students in the values of Jesus Christ and the teachings of the Catholic Church.
  
  Catholic Religious Education Programs are distinctive religious education establishments operated as programs of the Catholic Church; they are administered and supported by the sponsoring parish, and the diocese.
  
  Catholic Religious Education Programs are a collaborative faith effort between the Religious Education Program, the parents, and the students.
  
  While academic excellence and involvement in other extracurricular activities (i.e., sports, clubs, etc.) are important, committing to the schedule of the Religious Education Program is the fundamental priority.
  
  The Religious Education Program and its Coordinator have the responsibility to ensure that Catholic values and moral integrity permeate every facet of the program’s life and activities.
  
  In all questions involving faith, morals, faith teaching, and Church law, the final determination rests with the diocesan bishop. As a parent/guardian desiring to enroll my child in a Catholic Religious Education Program, I accept this memorandum of understanding. I pledge support for the Catholic identity and mission of this program, and by enrolling my child I commit myself to uphold all the principles and policies that govern a Catholic Religious Education Program.
  
  Saint Joseph Religious Education Attendance Policy
  (First Through Eighth Grade)
  
  Students will now be required to attend at least 80 percent of ALL Religious Education classes. This means that for the 2020-2021 Religious Education year, students will be allowed a total of FIVE (5) “ABSENCES” without penalty, and therefore no verification (such as a doctor’s note) is needed.
  
  Students who are more than 15 minutes late, or leave more than 15 minutes early will be marked as “LATE.” Three occurrences of being “LATE” will equal ONE “ABSENCE.”
  
  If a student exceeds the total number of allowable “ABSENCES”, they will have to repeat that grade level.
  
  ONLY IN GENUINE EXTENUATING CIRCUMSTANCES (such as a serious illness or a death in the immediate family) will exceptions be made to this attendance policy. ANY exceptions that are made will be at the discretion of both the Pastor and the Coordinator of Religious Education.
  
  I have read the above policies of the Saint Joseph Religious Education Program. I understand the terms of these policies and agree to abide by them. I acknowledge that failure to comply with these policies could lead to corrective action up to and including dismissal from the program.
  I Agree Please select this field.
  
  Student Media Release:
  We at Saint Joseph Parish are proud of the many great accomplishments that happen within the Religious Education Program, and we want to be able to share these great moments with you! By signing this release, you grant us permission to photograph and/or video your child or children during their Religious Education classes, and to use those photos and videos on our parish website, Facebook page, print publications, and future Religious Education promotion. The majority of the photos and videos taken are in either small or large groups, and we DO NOT publish students’ names in order to protect their privacy. Saint Joseph Parish respects either decision regarding this matter.
  
  Permission Statements REQUIRED I GIVE permission to have my child or children photographed or videoed. I DO NOT GIVE permission to have my child or children photographed or videoed. Please fill out this field.
  
  Electronic Signature of Legal Guardian Completing this form REQUIRED Please fill out this field. Please enter valid data.
  
  Child 4
  
  Name of child REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Child's Place of Birth: City and State REQUIRED Please fill out this field. Please enter valid data.
  
  Male or Female REQUIRED Please fill out this field.
  
  Child's Home Mailing Address REQUIRED Please fill out this field. Please enter valid data.
  
  Child's REP Grade for 2020-2021 REQUIRED Please fill out this field.
  
  Which session? REQUIRED Sunday, 9:30 AM (Preschool-Kindergarten) Monday, 4:00 PM - 5:30 PM (Grades 1-8) Monday, 6:30 PM - 8:00 PM (Grades 1-8) Wednesday 5:00 PM - 7:00 PM (Grades 9-12) Please fill out this field.
  
  School District REQUIRED Please fill out this field.
  
  Name of School Attending REQUIRED Please fill out this field.
  
  Sacraments Received REQUIRED Baptism Reconciliation First Holy Communion Confirmation Please fill out this field.
  
  Church of Baptism REQUIRED Please fill out this field. Please enter valid data.
  
  Church of Baptism City and State REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Allergic Reactions to medications, food, insects, etc. REQUIRED Please fill out this field. Please enter valid data.
  
  Child's current prescriptions and/or medications: (name, dose, frequency) REQUIRED Please fill out this field. Please enter valid data.
  
  Any special needs or other requests?
  
  Child's Medical/Psychological/etc. Condition(s) REQUIRED Please fill out this field. Please enter valid data.
  
  Physician's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Physician's Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Dentist's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Dentist's Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Mother's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Marital Status REQUIRED Single Married Widowed Separated Divorced Not married, living together Please fill out this field.
  
  Mother's Religion REQUIRED Catholic Christian Jewish None Other Please fill out this field.
  
  Mother's Email REQUIRED Please fill out this field. Please enter an email address.
  
  Mother's Mailing Address REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Mother's Work Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Mother's Home Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Father's First Name-Middle Name-Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Father's Marital Status REQUIRED Single Married Widowed Separated Divorced Not married, living together Please fill out this field.
  
  Father's Religion REQUIRED Catholic Christian Jewish None Other Please fill out this field.
  
  Father's Email REQUIRED Please fill out this field. Please enter an email address.
  
  Father's Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Father's Work Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Father's Home Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Full Name of Mother or Guardian Emergency Contact REQUIRED Please fill out this field. Please enter valid data.
  
  Mother/Guardian Emergency Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Full Name of Father or Guardian Emergency Contact REQUIRED Please fill out this field. Please enter valid data.
  
  Full Name of Father or Guardian Emergency Contact REQUIRED Please fill out this field. Please enter a phone number.
  
  Full Name of Primary Local Emergency Contact if Mother/Father/Guardian cannot be reached REQUIRED Please fill out this field. Please enter valid data.
  
  Primary Local Emergency Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Full Name of Secondary Local Emergency Contact if Mother/Father/Guardian cannot be reached REQUIRED Please fill out this field. Please enter valid data.
  
  Secondary Local Emergency Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Emergency Medical Authorization given by: REQUIRED Please fill out this field. Please enter valid data.
  
  In case of accident or serious illness, I request the Saint Joseph Religious Education office contact me or my designate. If this cannot be done, I authorize the Religious Education office to call the physician or dentist listed on this form and to follow his/her instructions. If the physician or dentist named cannot be reached, the Religious Education office may seek medical services that seem necessary. I realize the Religious Education office does not assume responsibility for the payment of medical expenses.
  I Agree Please select this field.
  
  Authorization REQUIRED Please fill out this field.
  
  Name of Legal Guardian agreeing to these statements: REQUIRED Please fill out this field. Please enter valid data.
  
  CATHOLIC RELIGIOUS EDUCATION PROGRAM PARENT(S) MEMORANDUM OF UNDERSTANDING
  As the parent(s) of a student in a Catholic Religious Education Program, I understand and affirm the following:
  
  The primary purpose of a Catholic Religious Education is to form students in the values of Jesus Christ and the teachings of the Catholic Church.
  
  Catholic Religious Education Programs are distinctive religious education establishments operated as programs of the Catholic Church; they are administered and supported by the sponsoring parish, and the diocese.
  
  Catholic Religious Education Programs are a collaborative faith effort between the Religious Education Program, the parents, and the students.
  
  While academic excellence and involvement in other extracurricular activities (i.e., sports, clubs, etc.) are important, committing to the schedule of the Religious Education Program is the fundamental priority.
  
  The Religious Education Program and its Coordinator have the responsibility to ensure that Catholic values and moral integrity permeate every facet of the program’s life and activities.
  
  In all questions involving faith, morals, faith teaching, and Church law, the final determination rests with the diocesan bishop. As a parent/guardian desiring to enroll my child in a Catholic Religious Education Program, I accept this memorandum of understanding. I pledge support for the Catholic identity and mission of this program, and by enrolling my child I commit myself to uphold all the principles and policies that govern a Catholic Religious Education Program.
  
  Saint Joseph Religious Education Attendance Policy
  (First Through Eighth Grade)
  
  Students will now be required to attend at least 80 percent of ALL Religious Education classes. This means that for the 2020-2021 Religious Education year, students will be allowed a total of FIVE (5) “ABSENCES” without penalty, and therefore no verification (such as a doctor’s note) is needed.
  
  Students who are more than 15 minutes late, or leave more than 15 minutes early will be marked as “LATE.” Three occurrences of being “LATE” will equal ONE “ABSENCE.”
  
  If a student exceeds the total number of allowable “ABSENCES”, they will have to repeat that grade level.
  
  ONLY IN GENUINE EXTENUATING CIRCUMSTANCES (such as a serious illness or a death in the immediate family) will exceptions be made to this attendance policy. ANY exceptions that are made will be at the discretion of both the Pastor and the Coordinator of Religious Education.
  
  I have read the above policies of the Saint Joseph Religious Education Program. I understand the terms of these policies and agree to abide by them. I acknowledge that failure to comply with these policies could lead to corrective action up to and including dismissal from the program.
  I Agree Please select this field.
  
  Student Media Release:
  We at Saint Joseph Parish are proud of the many great accomplishments that happen within the Religious Education Program, and we want to be able to share these great moments with you! By signing this release, you grant us permission to photograph and/or video your child or children during their Religious Education classes, and to use those photos and videos on our parish website, Facebook page, print publications, and future Religious Education promotion. The majority of the photos and videos taken are in either small or large groups, and we DO NOT publish students’ names in order to protect their privacy. Saint Joseph Parish respects either decision regarding this matter.
  
  Permission Statements REQUIRED I GIVE permission to have my child or children photographed or videoed. I DO NOT GIVE permission to have my child or children photographed or videoed. Please fill out this field.
  
  Electronic Signature of Legal Guardian Completing this form REQUIRED Please fill out this field. Please enter valid data.
  
  Child 5
  
  Mother's Mailing Address REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Mother's Work Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Mother's Home Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Father's First Name-Middle Name-Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Father's Marital Status REQUIRED Single Married Widowed Separated Divorced Not married, living together Please fill out this field.
  
  Father's Religion REQUIRED Catholic Christian Jewish None Other Please fill out this field.
  
  Father's Email REQUIRED Please fill out this field. Please enter an email address.
  
  Father's Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Father's Work Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Father's Home Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Full Name of Mother or Guardian Emergency Contact REQUIRED Please fill out this field. Please enter valid data.
  
  Mother/Guardian Emergency Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Full Name of Father or Guardian Emergency Contact REQUIRED Please fill out this field. Please enter valid data.
  
  Full Name of Father or Guardian Emergency Contact REQUIRED Please fill out this field. Please enter a phone number.
  
  Full Name of Primary Local Emergency Contact if Mother/Father/Guardian cannot be reached REQUIRED Please fill out this field. Please enter valid data.
  
  Primary Local Emergency Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Full Name of Secondary Local Emergency Contact if Mother/Father/Guardian cannot be reached REQUIRED Please fill out this field. Please enter valid data.
  
  Secondary Local Emergency Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Emergency Medical Authorization given by: REQUIRED Please fill out this field. Please enter valid data.
  
  In case of accident or serious illness, I request the Saint Joseph Religious Education office contact me or my designate. If this cannot be done, I authorize the Religious Education office to call the physician or dentist listed on this form and to follow his/her instructions. If the physician or dentist named cannot be reached, the Religious Education office may seek medical services that seem necessary. I realize the Religious Education office does not assume responsibility for the payment of medical expenses.
  I Agree Please select this field.
  
  Authorization REQUIRED Please fill out this field.
  
  Name of Legal Guardian agreeing to these statements: REQUIRED Please fill out this field. Please enter valid data.
  
  CATHOLIC RELIGIOUS EDUCATION PROGRAM PARENT(S) MEMORANDUM OF UNDERSTANDING
  As the parent(s) of a student in a Catholic Religious Education Program, I understand and affirm the following:
  
  The primary purpose of a Catholic Religious Education is to form students in the values of Jesus Christ and the teachings of the Catholic Church.
  
  Catholic Religious Education Programs are distinctive religious education establishments operated as programs of the Catholic Church; they are administered and supported by the sponsoring parish, and the diocese.
  
  Catholic Religious Education Programs are a collaborative faith effort between the Religious Education Program, the parents, and the students.
  
  While academic excellence and involvement in other extracurricular activities (i.e., sports, clubs, etc.) are important, committing to the schedule of the Religious Education Program is the fundamental priority.
  
  The Religious Education Program and its Coordinator have the responsibility to ensure that Catholic values and moral integrity permeate every facet of the program’s life and activities.
  
  In all questions involving faith, morals, faith teaching, and Church law, the final determination rests with the diocesan bishop. As a parent/guardian desiring to enroll my child in a Catholic Religious Education Program, I accept this memorandum of understanding. I pledge support for the Catholic identity and mission of this program, and by enrolling my child I commit myself to uphold all the principles and policies that govern a Catholic Religious Education Program.
  
  Saint Joseph Religious Education Attendance Policy
  (First Through Eighth Grade)
  
  Students will now be required to attend at least 80 percent of ALL Religious Education classes. This means that for the 2020-2021 Religious Education year, students will be allowed a total of FIVE (5) “ABSENCES” without penalty, and therefore no verification (such as a doctor’s note) is needed.
  
  Students who are more than 15 minutes late, or leave more than 15 minutes early will be marked as “LATE.” Three occurrences of being “LATE” will equal ONE “ABSENCE.”
  
  If a student exceeds the total number of allowable “ABSENCES”, they will have to repeat that grade level.
  
  ONLY IN GENUINE EXTENUATING CIRCUMSTANCES (such as a serious illness or a death in the immediate family) will exceptions be made to this attendance policy. ANY exceptions that are made will be at the discretion of both the Pastor and the Coordinator of Religious Education.
  
  I have read the above policies of the Saint Joseph Religious Education Program. I understand the terms of these policies and agree to abide by them. I acknowledge that failure to comply with these policies could lead to corrective action up to and including dismissal from the program.
  I Agree Please select this field.
  
  Student Media Release:
  We at Saint Joseph Parish are proud of the many great accomplishments that happen within the Religious Education Program, and we want to be able to share these great moments with you! By signing this release, you grant us permission to photograph and/or video your child or children during their Religious Education classes, and to use those photos and videos on our parish website, Facebook page, print publications, and future Religious Education promotion. The majority of the photos and videos taken are in either small or large groups, and we DO NOT publish students’ names in order to protect their privacy. Saint Joseph Parish respects either decision regarding this matter.
  
  Permission Statements REQUIRED I GIVE permission to have my child or children photographed or videoed. I DO NOT GIVE permission to have my child or children photographed or videoed. Please fill out this field.
  
  Electronic Signature of Legal Guardian Completing this form REQUIRED Please fill out this field. Please enter valid data.
  
  Name of child REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Child's Place of Birth: City and State REQUIRED Please fill out this field. Please enter valid data.
  
  Male or Female REQUIRED Please fill out this field.
  
  Child's Home Mailing Address REQUIRED Please fill out this field. Please enter valid data.
  
  Child's REP Grade for 2020-2021 REQUIRED Please fill out this field.
  
  Which session? REQUIRED Sunday, 9:30 AM (Preschool-Kindergarten) Monday, 4:00 PM - 5:30 PM (Grades 1-8) Monday, 6:30 PM - 8:00 PM (Grades 1-8) Wednesday 5:00 PM - 7:00 PM (Grades 9-12) Please fill out this field.
  
  School District REQUIRED Please fill out this field.
  
  Name of School Attending REQUIRED Please fill out this field.
  
  Sacraments Received REQUIRED Baptism Reconciliation First Holy Communion Confirmation Please fill out this field.
  
  Church of Baptism REQUIRED Please fill out this field. Please enter valid data.
  
  Church of Baptism City and State REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Allergic Reactions to medications, food, insects, etc. REQUIRED Please fill out this field. Please enter valid data.
  
  Child's current prescriptions and/or medications: (name, dose, frequency) REQUIRED Please fill out this field. Please enter valid data.
  
  Any special needs or other requests?
  
  Child's Medical/Psychological/etc. Condition(s) REQUIRED Please fill out this field. Please enter valid data.
  
  Physician's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Physician's Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Dentist's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Dentist's Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Mother's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Marital Status REQUIRED Single Married Widowed Separated Divorced Not married, living together Please fill out this field.
  
  Mother's Religion REQUIRED Catholic Christian Jewish None Other Please fill out this field.
  
  Mother's Email REQUIRED Please fill out this field. Please enter an email address.
Submit

Saint Joseph Catholic Church

Mechanicsburg, PA

2020-2021 Registration