RE Program 2019-2020 Registration Form

Kindergarten - 5th Grade

  • You must be a registered family at St. Pius to register for Religious Education, or have a letter of permission from your parish where you are registered.
  • Only one registration form per family is required for K-5th grade.

Please complete the information for each of the children who will be attending Religion Education K-5 on Sunday morning.

Family Contact Information
Is the Family registered at St.Pius X Church?
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FAMILY LAST NAME ON PARISH REGISTRATION
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Address
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Primary Phone --
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FATHER'S INFORMATION
Name
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Father is
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Religion
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E-mail
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Cell phone # --
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MOTHER'S INFORMATION
MAIDEN Name
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Mother is
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Religion
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E-mail
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Cell phone # --
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Emergency Contact
Name
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 Person to be reached during Religious Ed
Relationship to child
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Emergency Phone Number --
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Family Background
Parents are
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Children live with
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Family Ethnicity
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If other
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Permission
I give St.Pius X Church permission to print my child's name in the church bulletin or sacramental booklets
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I give permission for pictures and/or video of my child/children (named in this form) engaged in activities related to RE or parish event to have their pictures posted in St.Pius X publications or websites.
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If no box is checked the Diocese of Richmond and St.Pius X assumes you give permission.
Student 1
New registration of students requires Baptismal Certificate if Baptism was not done at St. Pius X.
The child is a
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Child's Name
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Birth Date //
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Gender
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Grade 2019-2020
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School 2019-2020
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Sacraments Completed
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Church, City, State, Country of Child's Baptism
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Special Requests/Needs
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Medical Condition or Allergies
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Student 2
New registration of students requires Baptismal Certificate if Baptism was not done at St. Pius X.
The child is a
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Child's Name
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Birth Date //
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Gender
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Grade 2019-2020
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Grade 2019-2020
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Sacraments Completed
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Church, City, State, Country of Child's Baptism
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Special Requests/Needs
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Medical Condition or Allergies
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Student 3
New registration of students requires Baptismal Certificate if Baptism was not done at St. Pius X.
The child is a
  •  
Child's Name
  •  
Birth Date //
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Gender
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Grade 2019-2020
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Grade 2019-2020
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Sacraments Completed
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Church, City, State, Country of Child's Baptism
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Special Requests/Needs
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Medical Condition or Allergies
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Please Note
THERE IS NO CHARGE FOR ST.PIUS X RELIGIOUS EDUCATION PROGRAMS. Though, we do require you make the following commitments:
I will contribute financially to St. Pius X Parish to the best of my ability.
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I will offer my time and talents in the following way(s) Check at least one:
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Name of the Person completing this form
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Parent Signature
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Once you submit this form, registration is not complete until payment is received in the parish office. Checks should be made to "St.Pius X Church" and specify RE registration and Family last name on the memo line.