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25-26 RE Registration

Religious Education / Catechism Class
Registration form
2025-2026

St. Dominic Catholic Church
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  Family's Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  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.
  
  Father's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Father's Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Father's Email Please enter an email address.
  
  Father's Language Preference: REQUIRED English Spanish Bilingual Please fill out this field.
  
  Mother's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Mother's Email Please enter an email address.
  
  Mother's Language Preference REQUIRED English Spanish Bilingual Please fill out this field.
  
  Preferred Contact REQUIRED Father Mother Either Please fill out this field.
  
  Emergency Contact Person REQUIRED Please fill out this field. Please enter valid data.
  
  Emergency Contact Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Emergency Contact Relationship to child? REQUIRED Please fill out this field. Please enter valid data.
  
  Number of Children or Youth you are registering Please fill out this field.
  
  Child or Youth 1
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  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.
  
  Male or Female REQUIRED Male Female Please fill out this field.
  
  Your child's grade level for the school year of 2025-2026. REQUIRED Please fill out this field. Please enter valid data.
  
  What Sacraments has your child already received? REQUIRED Baptism (in the Catholic Church) Eucharist Confirmation None Please fill out this field.
  
  Was your child's baptism in the Catholic Church REQUIRED Yes No (in another Christian denomination) My child has not been baptized Please fill out this field.
  
  Does your child have allergies? REQUIRED Yes No Please fill out this field.
  
  If yes, what is your child allergic to? Please enter valid data.
  
  Does your child have a learning disability? REQUIRED
  This information is kept private and will not be shared.
  Yes No Please fill out this field.
  
  If yes, what type of learning disability does your child have?
  This information is kept private and will not be shared
  Please enter valid data.
  
  By signing and submitting this registration form, I will receive a copy of the Religious Education Handbook, schedule, and I give permission for my child/children to participate in the Diocesan Safe Environment Program. REQUIRED Please fill out this field.
  
  I Agree Please select this field.
  
  Child or Youth 2
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  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.
  
  Male or Female REQUIRED Male Female Please fill out this field.
  
  Your child's grade level for the school year of 2025-2026. REQUIRED Please fill out this field. Please enter valid data.
  
  What Sacraments has your child already received? REQUIRED Baptism (in the Catholic Church) Eucharist Confirmation None Please fill out this field.
  
  Was your child's baptism in the Catholic Church REQUIRED Yes No (in another Christian denomination) My child has not been baptized Please fill out this field.
  
  Does your child have allergies? REQUIRED Yes No Please fill out this field.
  
  If yes, what is your child allergic to? Please enter valid data.
  
  Does your child have a learning disability? REQUIRED
  This information is kept private and will not be shared.
  Yes No Please fill out this field.
  
  If yes, what type of learning disability does your child have?
  This information is kept private and will not be shared
  Please enter valid data.
  
  By signing and submitting this registration form, I will receive a copy of the Religious Education Handbook, schedule, and I give permission for my child/children to participate in the Diocesan Safe Environment Program. REQUIRED Please fill out this field.
  
  I Agree Please select this field.
  
  Child or Youth 3
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  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.
  
  Male or Female REQUIRED Male Female Please fill out this field.
  
  Your child's grade level for the school year of 2025-2026. REQUIRED Please fill out this field. Please enter valid data.
  
  What Sacraments has your child already received? REQUIRED Baptism (in the Catholic Church) Eucharist Confirmation None Please fill out this field.
  
  Was your child's baptism in the Catholic Church REQUIRED Yes No (in another Christian denomination) My child has not been baptized Please fill out this field.
  
  Does your child have allergies? REQUIRED Yes No Please fill out this field.
  
  If yes, what is your child allergic to? Please enter valid data.
  
  Does your child have a learning disability? REQUIRED
  This information is kept private and will not be shared.
  Yes No Please fill out this field.
  
  If yes, what type of learning disability does your child have?
  This information is kept private and will not be shared
  Please enter valid data.
  
  By signing and submitting this registration form, I will receive a copy of the Religious Education Handbook, schedule, and I give permission for my child/children to participate in the Diocesan Safe Environment Program. REQUIRED Please fill out this field.
  
  I Agree Please select this field.
  
  Child or Youth 4
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  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.
  
  Male or Female REQUIRED Male Female Please fill out this field.
  
  Your child's grade level for the school year of 2025-2026. REQUIRED Please fill out this field. Please enter valid data.
  
  What Sacraments has your child already received? REQUIRED Baptism (in the Catholic Church) Eucharist Confirmation None Please fill out this field.
  
  Was your child's baptism in the Catholic Church REQUIRED Yes No (in another Christian denomination) My child has not been baptized Please fill out this field.
  
  Does your child have allergies? REQUIRED Yes No Please fill out this field.
  
  If yes, what is your child allergic to? Please enter valid data.
  
  Does your child have a learning disability? REQUIRED
  This information is kept private and will not be shared.
  Yes No Please fill out this field.
  
  If yes, what type of learning disability does your child have?
  This information is kept private and will not be shared
  Please enter valid data.
  
  By signing and submitting this registration form, I will receive a copy of the Religious Education Handbook, schedule, and I give permission for my child/children to participate in the Diocesan Safe Environment Program. REQUIRED Please fill out this field.
  
  I Agree Please select this field.
  
  Child or Youth 5
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  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.
  
  Male or Female REQUIRED Male Female Please fill out this field.
  
  Your child's grade level for the school year of 2025-2026. REQUIRED Please fill out this field. Please enter valid data.
  
  What Sacraments has your child already received? REQUIRED Baptism (in the Catholic Church) Eucharist Confirmation None Please fill out this field.
  
  Was your child's baptism in the Catholic Church REQUIRED Yes No (in another Christian denomination) My child has not been baptized Please fill out this field.
  
  Does your child have allergies? REQUIRED Yes No Please fill out this field.
  
  If yes, what is your child allergic to? Please enter valid data.
  
  Does your child have a learning disability? REQUIRED
  This information is kept private and will not be shared.
  Yes No Please fill out this field.
  
  If yes, what type of learning disability does your child have?
  This information is kept private and will not be shared
  Please enter valid data.
  
  By signing and submitting this registration form, I will receive a copy of the Religious Education Handbook, schedule, and I give permission for my child/children to participate in the Diocesan Safe Environment Program. REQUIRED Please fill out this field.
  
  I Agree Please select this field.
  
  Child or Youth 6
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  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.
  
  Male or Female REQUIRED Male Female Please fill out this field.
  
  Your child's grade level for the school year of 2025-2026. REQUIRED Please fill out this field. Please enter valid data.
  
  What Sacraments has your child already received? REQUIRED Baptism (in the Catholic Church) Eucharist Confirmation None Please fill out this field.
  
  Was your child's baptism in the Catholic Church REQUIRED Yes No (in another Christian denomination) My child has not been baptized Please fill out this field.
  
  Does your child have allergies? REQUIRED Yes No Please fill out this field.
  
  If yes, what is your child allergic to? Please enter valid data.
  
  Does your child have a learning disability? REQUIRED
  This information is kept private and will not be shared.
  Yes No Please fill out this field.
  
  If yes, what type of learning disability does your child have?
  This information is kept private and will not be shared
  Please enter valid data.
  
  By signing and submitting this registration form, I will receive a copy of the Religious Education Handbook, schedule, and I give permission for my child/children to participate in the Diocesan Safe Environment Program. REQUIRED Please fill out this field.
  
  I Agree Please select this field.
  
  Child or Youth 7
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  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.
  
  Male or Female REQUIRED Male Female Please fill out this field.
  
  Your child's grade level for the school year of 2025-2026. REQUIRED Please fill out this field. Please enter valid data.
  
  What Sacraments has your child already received? REQUIRED Baptism (in the Catholic Church) Eucharist Confirmation None Please fill out this field.
  
  Was your child's baptism in the Catholic Church REQUIRED Yes No (in another Christian denomination) My child has not been baptized Please fill out this field.
  
  Does your child have allergies? REQUIRED Yes No Please fill out this field.
  
  If yes, what is your child allergic to? Please enter valid data.
  
  Does your child have a learning disability? REQUIRED
  This information is kept private and will not be shared.
  Yes No Please fill out this field.
  
  If yes, what type of learning disability does your child have?
  This information is kept private and will not be shared
  Please enter valid data.
  
  By signing and submitting this registration form, I will receive a copy of the Religious Education Handbook, schedule, and I give permission for my child/children to participate in the Diocesan Safe Environment Program. REQUIRED Please fill out this field.
  
  I Agree Please select this field.
  
  Submit
  
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