Blessed Sacrament
Catholic Church & School

Register For 2018-2019

- Ministries

Important Note Before You Begin

***If you have MORE THAN one child you are registering, you need to fill out this form for each child individually. Submit one form per child.
The maximum number of form submissions has been reached. This form is currently not available.
- Name of person filling out this registration form? REQUIRED Please fill out this field. Please enter valid data.
- New family or continuing education? Continuing means your child attended classes in 2017-2018. REQUIRED Please fill out this field.
- Father's Name REQUIRED Please fill out this field. Please enter valid data.
- Father's Contact Number Please enter a phone number.
- Mother's Name REQUIRED Please fill out this field. Please enter valid data.
- Mother's Contact Number Please enter a phone number.
- Who should first be contacted in the event of a question or concern? Mother Father Other
- Who does the child primarily live with? Mother Father Both Other
- If other, please provide name, your relationship to child, and a contact number. Please enter valid data.
- Address where child lives? 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.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Parish Where Registered Blessed Sacrament Our Lady Queen Of Peace Other
- If other, please provide Church name and city Please enter valid data.
- Student Information
  
  Student's Last and First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Student's Date of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Student's Gender Male Female
  
  Student's Grade as of September 2018 REQUIRED Please fill out this field.
  
  Has your child been Baptized? Yes No
  
  If yes, what was the date of the child's Baptism? Please enter valid data.
  
  Parish where Baptized? Please enter valid data.
  
  Has your child completed their 1st Reconciliation? Yes No
  
  If yes, what was the date? Please enter valid data.
  
  Parish where 1st Reconciliation was completed? Please enter valid data.
  
  Has your child received their First Eucharist? Yes No
  
  If yes, what was the date? Please enter valid data.
  
  Parish where 1st Eucharist was received? Please enter valid data.
  
  Emergency Contact Information (This must be a non-parent who could pick up child if necessary)
- Name REQUIRED Please fill out this field. Please enter valid data.
- Relationship to child REQUIRED Please fill out this field. Please enter valid data.
- Phone REQUIRED Please fill out this field. Please enter valid data.
- Anything we need to know? REQUIRED
  Is there anything we should know about your child in order to better serve their needs in the program? Allergies? Asthma? Attention Deficit or Hyperactive Disorders? Learning Disabilities? Etc. Please describe. **This information will only be shared with the catechist as necessary. Otherwise it will be kept strictly confidential.
  Please fill out this field.
- Registration Fees
  1 child= $50
  2 children= $90
  3 children= $120
  4 children= $140
  
  *Note that this does not include any additonal potential fees such as retreats
- I would like to learn about tuition assistance. Yes No
- All done? Click submit.
Submit
Contact Us
- Michael Federman
  
  Director of Religious Education
  
  (920) 606-6595
  michael.federmanblessedsacramentmke.org

Register For 2018-2019

Registration Fees