Religious Ed Registration Form

PLEASE NOTE: Registration is for
grades Preschool through 8 only.

High School Students Register at elcatholics.org/youthministry

Child's Legal First Name Please enter valid data.

Middle Name Please enter valid data.

Last Name Please enter valid data.

Child's Common Name Please enter valid data.

PARENT'S LAST NAME IF DIFFERENT Please enter valid data.

Birth Date REQUIRED Please fill out this field. Please enter valid data.

City of Birth Please enter valid data.

Age REQUIRED Please fill out this field. Please enter valid data.

Gender REQUIRED Please fill out this field.

Grade in School REQUIRED Please fill out this field.

Name of School Please enter valid data.

PRIMARY ADDRESS INFORMATION

Primary Home Street address? 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.

House Phone (if available) Please enter valid data.

ALTERNATE ADDRESS INFORMATION

Which parent is alternate? Please enter valid data.

Street address? Please enter valid data.

City Please enter valid data.

State

Zip Please enter a zip code.

House Phone (if available) Please enter valid data.

FATHER'S INFORMATION

Father's First Name Please enter valid data.

Father's Last Name Please enter valid data.

Father's Cell Phone Number Please enter a phone number.

Father's Email Please enter an email address.

Father's Religion Please enter valid data.

MOTHER'S INFORMATION

Mother's First Name Please enter valid data.

Mother's Last Name Please enter valid data.

Mother's Cell Phone Number Please enter a phone number.

Mother's Email Please enter an email address.

Mother's Religion Please enter valid data.

CLASS AND SACRAMENTAL INFORMATION

Class Times Sunday 10:05am - 10:55am (Pre-8) Monday 4:30pm - 5:30pm (Pre-8) Online Classes - Grades 1 - 8 only Adult Program - 10:05am - 10:55am Sunday - no charge

High School: Please use Youth Group form to register

Allergies / Health / Learning Problems

Special Requests

Baptism REQUIRED Yes No Please fill out this field.

Date (if known) Please enter valid data.

Church of Baptism Please enter valid data.

City and State for Church of Baptism Please enter valid data.

First Penance REQUIRED Yes No Please fill out this field.

First Eucharist REQUIRED Yes No Please fill out this field.

Confirmation REQUIRED Yes No Please fill out this field.

IN CASE WE CAN'T REACH YOU,
WHO CAN WE CALL?

EMERGENCY CONTACT FIRST NAME REQUIRED Please fill out this field. Please enter valid data.

EMERGENCY CONTACT 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.

Permissions and Disclaimers.
Included in this section are Participation Release Form, Diocese of Lansing - Media Release Form, Communication Release Form. The full language or a hard copy can be accessed HERE

When you click YES on each of these buttons, you are agreeing and authorizing St. Thomas Aquinas.

Your YES will act as your personal signature and dating of the document.

Participation Release - my child has my permission to participate in activities. REQUIRED Please fill out this field.

Media Release - the Diocese of Lansing has permission to use the image of my child. REQUIRED Please fill out this field.

Communication Release - the staff of STA or SJSC may be communicating with members of our family REQUIRED Please fill out this field.