Religious Ed Registration Form

Please complete the form below to register for religious education at St. Anthony of Padua. Please note: Children registering to receive a sacrament must be enrolled and attending classes by October 1st.

Faith Formation Registration

We are asking all registrants to fill out this form. It helps us to ensure we have correct data. Thank you for your understanding!

Family Information
Title
- Mother
- Father
- Stepmother
- Stepfather
- Guardian
Name*
First Last
Phone*
Text OK?*
- Yes
- No
Email*
Please List Fluent Languages
Title
- Mother
- Father
- Stepmother
- Stepfather
- Guardian
Name
First Last
Phone
Email
Please List Fluent Languages
Family Mailing Address*
Street Address Address Line 2 City State ZIP Code
Kids Reside With:
- Father & Mother
- Father & Stepmother
- Stepfather & Mother
- Mother Only
- Father Only
- Legal Guardian
Number of Students Registering*
Please enter a number from 1 to 6.
Student #1 Information
Student Name*
First Last
Gender
- Boy
- Girl
Birth Date*
MM slash DD slash YYYY
Health Issues/Disability
Age Group*
Grade*
- Kindergarten
- 1st Grade
- 2nd Grade
- 3rd Grade
- 4th Grade
- 5th Grade
Grade*
- 6th Grade
- 7th Grade
- 8th Grade
Grade*
- 9th Grade
- 10th Grade
- 11th Grade
- 12th Grade
Is your child baptized?*
- Yes
- No
Baptism Information*
Please provide date, church, city and state of Baptism.
I would like Baptism for my child*
- Yes
- No
Has your child received First Reconciliation & First Communion?*
- Yes
- No
First Reconciliation & First Communion Information*
Please provide date, church, city and state of First Reconciliation & First Communion.
I would like First Reconciliation & First Communion for my child*
- Yes
- No
Has your child been Confirmed?*
- Yes
- No
Confirmation Information*
Please provide date, church, city and state of Confirmation.
I would like Confirmation for my child*
- Yes
- No
Sacrament Prep Needed?
Student #2 Information
Student Name*
First Last
Gender
- Boy
- Girl
Birth Date*
MM slash DD slash YYYY
Health Issues/Disability
Age Group
Grade*
- Kindergarten
- 1st Grade
- 2nd Grade
- 3rd Grade
- 4th Grade
- 5th Grade
Grade*
- 6th Grade
- 7th Grade
- 8th Grade
Grade*
- 9th Grade
- 10th Grade
- 11th Grade
- 12th Grade
Is your child baptized?*
- Yes
- No
Baptism Information*
Please provide date, church, city and state of Baptism.
I would like Baptism for my child*
- Yes
- No
Has your child received First Reconciliation & First Communion?*
- Yes
- No
First Reconciliation & First Communion Information*
Please provide date, church, city and state of First Reconciliation & First Communion.
I would like First Reconciliation & First Communion for my child*
- Yes
- No
Has your child been Confirmed?*
- Yes
- No
Confirmation Information*
Please provide date, church, city and state of Confirmation.
I would like Confirmation for my child*
- Yes
- No
Sacrament Prep Needed This Year?
Student #3 Information
Student Name*
First Last
Gender
- Boy
- Girl
Birth Date*
MM slash DD slash YYYY
Health Issues/Disability
Age Group
Grade*
- Kindergarten
- 1st Grade
- 2nd Grade
- 3rd Grade
- 4th Grade
- 5th Grade
Grade*
- 6th Grade
- 7th Grade
- 8th Grade
Grade*
- 9th Grade
- 10th Grade
- 11th Grade
- 12th Grade
Is your child baptized?*
- Yes
- No
Baptism Information*
Please provide date, church, city and state of Baptism.
I would like Baptism for my child*
- Yes
- No
Has your child received First Reconciliation & First Communion?*
- Yes
- No
First Reconciliation & First Communion Information*
Please provide date, church, city and state of First Reconciliation & First Communion.
I would like First Reconciliation & First Communion for my child*
- Yes
- No
Has your child been Confirmed?*
- Yes
- No
Confirmation Information*
Please provide date, church, city and state of Confirmation.
I would like Confirmation for my child*
- Yes
- No
Sacrament Prep Needed?
Student #4 Information
Student Name*
First Last
Gender
- Boy
- Girl
Birth Date*
MM slash DD slash YYYY
Health Issues/Disability
Age Group
Grade*
- Kindergarten
- 1st Grade
- 2nd Grade
- 3rd Grade
- 4th Grade
- 5th Grade
Grade*
- 6th Grade
- 7th Grade
- 8th Grade
Grade*
- 9th Grade
- 10th Grade
- 11th Grade
- 12th Grade
Is your child baptized?*
- Yes
- No
Baptism Information*
Please provide date, church, city and state of Baptism.
I would like Baptism for my child*
- Yes
- No
Has your child received First Reconciliation & First Communion?*
- Yes
- No
First Reconciliation & First Communion Information*
Please provide date, church, city and state of First Reconciliation & First Communion.
I would like First Reconciliation & First Communion for my child*
- Yes
- No
Has your child been Confirmed?*
- Yes
- No
Confirmation Information*
Please provide date, church, city and state of Confirmation.
I would like Confirmation for my child*
- Yes
- No
Sacrament Prep Needed?
Student #5 Information
Student Name*
First Last
Gender
- Boy
- Girl
Birth Date*
MM slash DD slash YYYY
Health Issues/Disability
Age Group
Grade*
- Kindergarten
- 1st Grade
- 2nd Grade
- 3rd Grade
- 4th Grade
- 5th Grade
Grade*
- 6th Grade
- 7th Grade
- 8th Grade
Grade*
- 9th Grade
- 10th Grade
- 11th Grade
- 12th Grade
Is your child baptized?*
- Yes
- No
Baptism Information*
Please provide date, church, city and state of Baptism.
I would like Baptism for my child*
- Yes
- No
Has your child received First Reconciliation & First Communion?*
- Yes
- No
First Reconciliation & First Communion Information*
Please provide date, church, city and state of First Reconciliation & First Communion.
I would like First Reconciliation & First Communion for my child*
- Yes
- No
Has your child been Confirmed?*
- Yes
- No
Confirmation Information*
Please provide date, church, city and state of Confirmation.
I would like Confirmation for my child*
- Yes
- No
Sacrament Prep Needed?
Student #6 Information
Student Name*
First Last
Gender
- Boy
- Girl
Birth Date*
MM slash DD slash YYYY
Health Issues/Disability
Age Group
Grade*
- Kindergarten
- 1st Grade
- 2nd Grade
- 3rd Grade
- 4th Grade
- 5th Grade
Grade*
- 6th Grade
- 7th Grade
- 8th Grade
Grade*
- 9th Grade
- 10th Grade
- 11th Grade
- 12th Grade
Is your child baptized?*
- Yes
- No
Baptism Information*
Please provide date, church, city and state of Baptism.
I would like Baptism for my child*
- Yes
- No
Has your child received First Reconciliation & First Communion?*
- Yes
- No
First Reconciliation & First Communion Information*
Please provide date, church, city and state of First Reconciliation & First Communion.
I would like First Reconciliation & First Communion for my child*
- Yes
- No
Has your child been Confirmed?*
- Yes
- No
Confirmation Information*
Please provide date, church, city and state of Confirmation.
I would like Confirmation for my child*
- Yes
- No
Sacrament Prep Needed?
Emergency Contact
Name*
First Last
Phone*
Relationship
Pick-Up Authorization
Please list additional persons authorized to pick-up your child(aren). Photo ID will be required at pick-up.
Name Relationship Phone
Volunteer Information
Classroom Opportunities
- Teacher
- Teacher's Aide
- Substitute Teacher
Please Note: Background Check and Safe Environment Training Needed
Media Release
Photography Waiver
I agree
By checking this box I grant permission to use my child’s (children's)/youth name, likeness and/or photographic image in the production of brochures, newsletters, websites, newspapers, etc.
CAPTCHA
Total Cost
Product Name
Price:
Payment can be dropped off at the Shepard Staff Parish Offices or paid securely online. An online link will be given to you after you submit the form.
2 or More Students
Price:
Payment can be dropped off at the Shepard Staff Parish Offices or paid securely online. An online link will be given to you after you submit the form.

Faith Formation Registration

Family Information

Student #1 Information

Student #2 Information

Student #3 Information

Student #4 Information

Student #5 Information

Student #6 Information

Emergency Contact

Pick-Up Authorization

Volunteer Information

Media Release

Total Cost

Our Address

Office Hours

Get In Touch

Name	Relationship	Phone