Saint Ann Parish Return to: Religious Ed Office

481 Brewster Street, Bridgeport, CT 06605

(203) 368-1607 extension 101

Religious Education/Sacramental Preparation Class Registration Form (please PRINT)

Family’s Last Name: ______First Names (Parents):______

Address: ______Home Phone: (______)______

______Cell Phones: (______)______(______)______

Emergency

Contact:______Emerg. Phone:(______)______

Custodial Parent: ______Email ______

Rel Ed Mailing Address______Parish You are Registered At: ______

(if different from above)

______Both Parents Catholic? Y N ______

Child #1 – Name (Last, First)BirthdateGenderGrade in Sept. SchoolRegistering For:

Pub. Schl ____

______1st Rec____ 1stComm ____ Conf ____

Sacraments Already Received: Baptism Catholic? Date/Church: ______Reconciliation Date/Church: ______

Eucharist Date/Church: ______

(New students, please include a copy of sacramental certificate including parish name where received with completed registration)

Special Needs (Medical, allergies, learning/physical disabilities: ______

Child #2 – Name (Last, First)BirthdateGenderGrade in Sept. SchoolRegistering For:

Pub. Schl ____

______1st Rec____ 1stComm ____ Conf ____

Sacraments Already Received: Baptism Catholic? Date/Church: ______Reconciliation Date/Church: ______

Eucharist Date/Church: ______

(New students, please include a copy of sacramental certificate including parish name where received with completed registration)

Special Needs (Medical, allergies, learning/physical disabilities: ______

Child #3 – Name (Last, First)BirthdateGenderGrade in Sept. SchoolRegistering For:

Pub. Schl ____

______1st Rec____ 1stComm ____ Conf ____

Sacraments Already Received: Baptism Catholic? Date/Church: ______Reconciliation Date/Church: ______

Eucharist Date/Church: ______

(New students, please include a copy of sacramental certificate including parish name where received with completed registration)

Special Needs (Medical, allergies, learning/physical disabilities: ______

NOTES

The Catholic Church believes that parents are the primary faith educators of our children.

Faithful attendance at Sunday Mass nourishes your child’s faith and fosters a greater relationship with God,

as well as creates a sense of belonging to our larger faith community.

Attendance at Sunday Mass is a base requirement for our Faith Formation Program.

Our Sunday Mass times are provided on the Faith Formation Calendar.

Tuition and Fee Schedule 2016-17

*Please make checks payable to St. Ann Church*

Tuition (if received before 7/1/2016): one child $50; two children $75; maximum family $100

Tuition (if received after 7/1/2016): one child $75; two children $100; maximum family $125

Sacramental Year Two (Communion): Tuition fee plus $50 per child in the Sacramental Prep program

Sacramental Year Eight (Confirmation Prep): Tuition fee plus $75.00 per child in the Confirmation prep program

A note regarding tuition and fees: We recognize that some families may not be in the financial position to pay these fees. We will work with each family on an individual basis to ensure that all children may participate. Also, children of adults who volunteer as either a catechist or catechist aide do not pay any

religious education tuition or fees.

Please contact the Religious Ed Office before July 1st to discuss financial options/payment plan if needed

Volunteering to help others in the classroom benefits the family and parish alike!

______

Check any that may apply:

______Please contact me regarding scholarship assistance (or I would like to donate to a Scholarship Fund)

______I would like to volunteer as a _____ Catechist (must be at least 18) or as a _____ Catechist Aide.

Grade interested in teaching_____Daytime Phone: ______

NOTE: (Catechist’s children do NOT pay any religious education tuition/fees - no experience needed)

Please contact Religious Ed Office (203-368-1607, extension 101; ) with any questions.

______

Dear Parent/Guardians of Religious Ed Children,

For the safety and protection of all children, we will continue our“sign out” policy. Each person who has permission to pick up your child/children after class must be listed below. If your child will be walking home, please indicate below and sign acknowledging consent. We understand that emergencies or various things come up changing plans but if something last minute comes up would you please send your child with a note or email the office indicating if it is a different person than is listed below. We need written confirmation before we release your child to someone. This is very much for the protection and safety of your children. Thank you so much for your understanding and compliance.

LIST ALL ADULTS APPROVED FOR PICKUP: ______

______

______

Parent Signature Emergency # or cell# to reach you during class time

______

REGISTRATION FEE SUMMARY (For Office Use Only)

Religious ED (tuition)):Tuition Total ______

Religious ED (sacramental fee):Tuition Total ______

Donation to the Scholarship Fund:Scholarship Donation ______

TOTAL ENCLOSED:Grand Total______