Our Lady of the Mountain Religious Education Program
OUR LADY OF THE MOUNTAIN RELIGIOUS EDUCATION PROGRAM
2 East Springtown Road, Long Valley, NJ 07853 – 908-876-4003 –
KINDERGARTEN THROUGH GRADE 10
REGISTRATION (AND RE-REGISTRATION) FOR 2017-2018
RE-REGISTRATIONS WILL NOT BE ACCEPTED AFTER OCTOBER 1, 2017!
Please provide the following information and return this form along with the tuition fee to the address above by July 31, 2017. The tuition cost per child remains at $100; however there is a $25.00 fee PER FAMILY to cover increased operating costs (i.e., books, supplies). REGISTRATIONS RECEIVED AFTER JULY 31ST WILL INCUR AN ADDITIONAL $50 LATE FEE TO COVER ADDITIONAL SHIPPING EXPENSES FOR BOOKS. Please make checks payable to Our Lady of the Mountain Religious Education Program. Children will not be placed in a class until this form, any required documentation and applicable tuition (and late fee if applicable) is returned.
PLEASE NOTE FOR NEW STUDENTS: For students in Grades 2 and up, proof of prior religious education in the form of a letter from the Director of Religious Education of the previous parish must be provided. A copy of a Baptism certificatefor all new registrations must also be provided with this form, but only if the Baptism did not occur at Our Lady of the Mountain. Registration will not be processed without receipt of all these forms.
Tuition Fees: GRADES K-9:$100.00 PER CHILD PLUS $25 FEE PER FAMILY
GRADE 10:$150.00 (Confirmation Retreat Fee Included)
($400 cap per family, includingfamily fee.)
PLEASE PRINT CLEARLYToday’s Date:______
FAMILY NAME: (Only if different from child’s last name.) ______
Father’s First and Last Name:______Religion:______
Mother’s First and MAIDEN NAME:______Religion:______
Street Address:______City/State/Zip: ______
*Cell Phone: Mother: ______Father: ______Home: ______
*Please note that the cell phone numbers will be used as a primary phone number.
Family Email Address:** ______
**Please be sure to provide an email address as mostly all communication will be sent via email.
Non-Parent Emergency Contact Name: ______Phone:______
Relation to Child: ______
GRADES K-6 ONLY:
Classes meet every Sunday morning. Please indicate your 1st, 2nd and 3rd choices for the Session desired. Since space in each Session is limited, availability will be given on a first-come, first-serve basis. Please be sure to send back your form and tuition as soon as possible in order to secure your Session choice.
Session A:8:00AM-9:00AM______
Session B:9:30AM-10:30AM______
Session C:11:00AM-12:00PM______
GRADES 78: Alternating Monday evenings, 6:00-7:15PMGrade 7 will meet on the same evening as Grade 9
GRADES 9 & 10: Alternating Monday evenings, 7:30-9:00PMGrade 8 will meet on the same evening as Grade 10
PLEASE CONTINUE ON NEXT PAGE OR REVERSE SIDE
STUDENT INFORMATION: If you are enrolling more than 4 children, please indicate the below information on an additional sheet of paper and attach it to this form. If you are re-registering, you need not fill out the Sacramental information for your child(ren)unless you are registering a child for the first time; but please do indicate if there are any health issues or learning disabilities that we should know about.
First Child:
Name:______Boy:_____ Girl:_____ Date of Birth:______Rel. Ed. Grade 2017-2018:______
Name and Address of Church of Baptism: ______Date:______
Name and Address of Church of First Reconciliation: ______Grade: ______
Name and Address of Church of First Eucharist:______Grade:______
Please indicate any health issues or learning disabilities:*______
______
Second Child:
Name:______Boy:_____ Girl:_____ Date of Birth:______Rel. Ed. Grade 2017-2018:______
Name and Address of Church of Baptism: ______Date:______
Name and Address of Church of First Reconciliation: ______Grade: ______
Name and Address of Church of First Eucharist:______Grade:______
Please indicate any health issues or learning disabilities:*______
______
Third Child:
Name:______Boy:_____ Girl:_____ Date of Birth:______Rel. Ed. Grade 2017-2018:______
Name and Address of Church of Baptism: ______Date:______
Name and Address of Church of First Reconciliation: ______Grade: ______
Name and Address of Church of First Eucharist:______Grade:______
Please indicate any health issues or learning disabilities:*______
______
Fourth Child:
Name:______Boy:_____ Girl:_____ Date of Birth:______Rel. Ed. Grade 2017-2018:______
Name and Address of Church of Baptism: ______Date:______
Name and Address of Church of First Reconciliation: ______Grade: ______
Name and Address of Church of First Eucharist:______Grade:______
Please indicate any health issues or learning disabilities:*______
*All health issues and learning disabilities shared on this form will be held in the strictest confidence. If, however, you are uncomfortable sharing such information on this form and wish to speak to the Director of Religious Education, please call 908-876-4003.