PREP Registration

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Student's First Name REQUIRED Please fill out this field. Please enter valid data.
Student's Last Name REQUIRED Please fill out this field. Please enter valid data.
Date of Birth REQUIRED Please fill out this field. Please enter valid data.
Age REQUIRED Please fill out this field. Please enter valid data.
Date and Place of Baptism REQUIRED Please fill out this field. Please enter valid data.
School REQUIRED Please fill out this field. Please enter valid data.
Grade REQUIRED Please fill out this field. Please enter valid data.
Father's Full Name REQUIRED Please fill out this field. Please enter valid data.
Father's Religion REQUIRED Please fill out this field. Please enter valid data.
Father's Email REQUIRED Please fill out this field. Please enter valid data.
Father's Phone REQUIRED Please fill out this field. Please enter valid data.
Okay to Text REQUIRED Yes No Please fill out this field.
Mother's Full Name REQUIRED Please fill out this field. Please enter valid data.
Mother's Religion REQUIRED Please fill out this field. Please enter valid data.
Mother's Email Please enter valid data.
Mother's Phone REQUIRED Please fill out this field. Please enter valid data.
Okay to Text REQUIRED Yes No Please fill out this field.
Is your family registered with St. Paul's Catholic Church? REQUIRED Yes No Please fill out this field.
Street 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.
Emergency Contact Name & Relationship REQUIRED Please fill out this field. Please enter valid data.
Emergency Contact Phone Number REQUIRED Please fill out this field. Please enter valid data.
Any allergies, medications, special health needs this child has that we should know about? REQUIRED Yes, describe below No Please fill out this field.
If yes, please explain health needs below
Is there anything we need to know of to be of better assistance to this child? (i.e. learning needs, special needs, areas of sensitivity, family situation, ect.) The information submitted is confidential. REQUIRED Yes, describe below No Please fill out this field.
If yes, please explain needs below
Total previous years in Catholic Religious Education REQUIRED Please fill out this field. Please enter valid data.
Which mass time do you attend? REQUIRED Saturday, 4pm Sunday, 9am Sunday, 11am Sunday, 7pm Please fill out this field.
My child will be receiving the Sacraments of Penance/Communion this year (your child must be in second grade or older and have had a least 1 year prior religious education) REQUIRED Yes No Please fill out this field.
My child will be receiving the Sacrament of Confirmation this year (your child must be in eighth grade, have made their other Sacraments, and have had at least 1 year prior religious education) REQUIRED Yes No Please fill out this field.

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