- ST. LEO’S/HOLY ROSARY PARISH
ASHLEY, PA
RELIGIOUS EDUCATION REGISTRATION FORM
I AM REGISTERING MY CHILD FOR THE FOLLOWING: (Please check all that apply.)
_______C.C.D. Classes______ First Penance______ First Communion_______ Confirmation
STUDENT’S NAME:___________________________________________________________________
STUDENT’S ADDRESS:___________________________________________________________________________
STUDENT’S DATE AND PLACE OF BIRTH: ________________________________________________________________
STUDENT’S PRESENT SCHOOL:_______________________________________GRADE _________
CHURCH & DATE OF STUDENT’S BAPTISM:_____________________________________________
(Within two weeks, please submit a copy of your child’s Baptismal certificate if he/she was not baptized in this parish.)
CHURCH & DATE OF STUDENT’S FIRST PENANCE:______________________________________
CHURCH & DATE OF STUDENT’S FIRST COMMUNION:___________________________________
THE STUDENT _________IS __________IS NOT A MEMBER OF THIS PARISH.
(CHECK ONE)
(If the student is not a member of this parish, a letter from the child’s current pastor which allows for religious instruction at St. Leo’s/Holy Rosary must be sent to Father Dang within two weeks. The letter must also indicate the dates of the child’s attendance at the home parish’s religious education program.)
WHERE DID THE STUDENT ATTEND RELIGIOUS INSTRUCTION DURING 2020-2021?
_____________________________________________________________________________________
PLEASE LIST ANY CONDITIONS WHICH MAY AFFECT STUDENT’S ATTENDANCE OR CLASSROOM CONDUCT:_____________________________________________________________
PARENT/GUARDIAN’S NAME:_________________________________________________________
PARENT/GUARDIAN’S ADDRESS:______________________________________________________
PARENT/GUARDIAN’S PHONE:_________________________________________________________
PARENT/GUARDIAN’S EMAIL ADDRESS: ______________________________________________
ARE YOU A MEMBER OF ST. LEO’S/HOLY ROSARY PARISH?________YES_______NO
EMERGENCY CONTACT(NAME):______________________________________________________________
PHONE:__________________________RELATION TO STUDENT_____________________________