Religious Education Registration Form

2019-2020
Religious Education Registration

Now Open!

St. Joseph Parish is excited to now offer online registration.  We hope this new option will be more convenient for you, while also helping us to obtain be more accurate and current information for our records.  We are always striving to create the best RE program possible, and keeping a stronger connection with our students and families will aide us in that goal.  

Since plans are well underway for the 2019-2020 year, it is very important that every family completes and submits their registration as soon as possible. To ensure your child(ren)'s spot in class as well as a textbook and other supplies, please submit your registration by July 22, 2019.  

Completed registrations will recieve a confirmation email. Please watch your mail and email throughout the summer for future communications, including the 2019-2020 RE Calendar. 

We look forward to a great year and are very grateful to be a part of your family's faith journey!  

Feel free to contact Jennifer Hoge (jhoge@stjosephbradley.org) or Anita Lovell (alovell@stjosephbradley.org) or call the RE Office 815-937-9340 with any questions.

RE Registration Instructions: 

STEP 1:Please fill out forms below.
~Please provide complete and accurate information for EVERY field possible, for each child being registered. 

~Rather than leaving blank, please reply "N/A" when non-applicable. 
~If you would prefer, a downloadable PDF version is available. You can download and print and return to St. Joseph Religious Education Office or send via email.  

STEP 2) Pay Tuition
(Registrations are not considered final until a payment is received).
Currently we are unable to accept payments online
~ We ask for a minimum deposit of 50.00 at the time of registration
~ Check made payable to St. Joseph Religius Education
~ To finalize registration, place payment in an envelope ATTN. To: Religous Education and:
         1)Drop off in Offeratory basket during Mass on Sundays
         2) Drop off at the Parish Office (located on Perry Street). A mail slot is available for payments in a marked envelope.
        3) Mail payment to: St. Joseph Parish
                                          ATTN: RE
                                         211 North Center
                                         Bradley, IL 60915

Please Note the following:

Any outstanding tuition from 2018-2019 MUST BE PAID at the time of registration or no later than June 20, 2019 in order to secure a spot for 2019-2020.

All 2019-2020 Tuition Must be
paid in full by September 30, 2019, or a minimum 15.00 late fee may be applied.

Please contact the Religious Education Office to discuss possible payment plan options, should the need arise.

ATTENTION TO FAMILIES WITH NEW or TRANSFER STUDENTS: 
A copy of his/her baptismal certificate is required for any student who was NOT baptized at St. Joseph Parish. 
Registration will not be finalized without all of the required paperwork and payment.

Parish Membership Status
Family Last Name
  •  
Are you a registered parishioner?
  •  
My St. Joseph Registration Number
  •  
I am registered at a different parish:
  •  
Tuition/Number of Students Attending 2019-2020
Tuition Agreement
  •  
Total Number of children enrolled
  •  
Family Contact Information
Mail should be sent to the attention of:
  •  
(For example: Mr. & Mrs. Joe ... Ms. Jane ... Dr. & Mrs ...
Mailing Address
  •  
Home/Preferred Phone --
  •  
Family Preferred Email
  •  
Please provide an email that is monitored regularly, as this email will be used for all RE Communications.
Children Live with (Select all that apply)
  •  
If Other, please specify
  •  
Primary Language Spoken
  •  
If Language is Other than English ...
  •  
Father's Name
  •  
Father's Phone -- ext
  •  
Father's Email
  •  
Please type N/A, if not applicable
Father's Religion (Required for Church Records)
  •  
Father's Religion-if not Catholic
  •  
Please type N/A , if not applicable
Mother's Name
  •  
Mother's Maiden Name (REQUIRED for Sacramental Records)
  •  
Mother's Phone -- ext
  •  
Mother's Primary Email
  •  
Please type N/A if not applicable
Mother's Religion (Required for Church Records)
  •  
Mother's Religion, if not Catholic
  •  
Please type N/A, if not applicable
COMMUNICATIONS: Additional Household
Is there an additional household that should receive Religious Educations communications (calendars, newsletters, announcements, etc.) should be mailed? (For example, other parent, a grandparent, etc), please enter it here
Please select which type of communications to send to an ADDITIONAL household
  •  
Information will be sent to both home and additional address/email. This is for informative purposes only; THIS IS NOT AN EMERGENCY CONTACT
Message Please mail the selected communications to the following
Name
  •  
Address
  •  
E-mail
  •  
Relationship to the Child(ren)
  •  
Child 1:Information
Please fully complete for each child being registered into Religious Education
Child 1 to enter what Religious Education grade in 2019
  •  
Child 1 Name
  •  
Child 1 Nick Name/Preferred Name
  •  
Child 1 Gender
  •  
Birth Date //
  •  
Place of Birth
  •  
School Attending in Fall of 2019
  •  
School Grade in Fall of 2019
  •  
Did Child attend Religious Education or Catholic school last year?
  •  
If yes, where did child attend Religious Education last year?
  •  
Please reply N/A, if not applicable
What grade in Religious Education or Catholic School last year?
  •  
Child 1: Sacramental Information
This sections if for NEW or TRANSFER students only. Note:A copy of child's baptismal certificate is required for any student not baptized at St. Joseph Parish.
This child has received the following sacraments:
  •  
Date and Church of Baptism
  •  
Date and Church of First Communion
  •  
Child 1: Special Needs/Allergies
For your child's safety as well as helping us to best meet your child's needs, please note any special needs, concerns (learning, behavior, or health) and allergies. You may also send any procedure plans to Religious Education Office, if needed.
Special Needs
  •  
So that we can best meet your child's needs, please note any special needs or concerns (learning, behavior, or health). You may also send any procedure plans to Religious Education Office, if needed.
Please list any food/drink ALLERGIES
  •  
N/A, if not applicable
Please indicate your preference for this child consuming food/drink during RE Sessions
  •  
Please do NOT allow my child to eat/drink the following
  •  
Child 2: Information
Child 2 to enter what Religious Education grade in 2019
  •  
Child 2: Name
  •  
Child 2: Nick Name/Preferred Name
  •  
Child 2: Gender
  •  
Child 2: Birth Date //
  •  
Child 2: Place of Birth
  •  
Child 2: Name of School Attending in the fall of 2019
  •  
Child 2: School Grade in Fall 2019
  •  
Did Child attend Religious Education or Catholic school last year?
  •  
If yes, where did he/she attend?
  •  
What grade did he/she attend in RE last year?
  •  
Child 2: Sacramental Information
This sections if for NEW or TRANSFER students only. Note:A copy of child's baptismal certificate is required for any student not baptized at St. Joseph Parish.
Child 2 has received the following sacraments
  •  
Date and Church of Baptism (Include City,State)
  •  
Date and Church of First Communion (Include City, State)
  •  
Child 2: Special Needs/Allergies
For your child's safety as well as helping us to best meet your child's needs, please note any special needs, concerns (learning, behavior, or health) and allergies. You may also send any procedure plans to Religious Education Office, if needed.
Please list any special needs or concerns
  •  
N/A, if not applicable
Please list ANY FOOD/DRINK ALLERGIES
  •  
N/A, if not applicable
Please indicate your preference for this child consuming food/drink during class.
  •  
Please do NOT allow my child to eat/drink the following
  •  
Child 3: Information
Grade Child 3 to enter in Religious Education 2019
  •  
Child 3 Name
  •  
Child 3 Nickname/Preferred Name
  •  
Child 3 Gender
  •  
Child 3: Birthdate //
  •  
Child 3: Place of Birth
  •  
Child 3: Name of School Attending in the fall of 2019
  •  
Child 3: School Grade in Fall 2019
  •  
Did Child attend Religious Education or Catholic school last year?
  •  
If yes, where did he/she attend?
  •  
What grade in Religious Education or Catholic School last year?
  •  
Child 3: Sacramental Information
This sections if for NEW or TRANSFER students only. Note:A copy of child's baptismal certificate is required for any student not baptized at St. Joseph Parish.
Child 3 has received the following sacraments
  •  
Date and Church of Baptism (Include City,State)
  •  
Date and Church of First Communion (Include City, State)
  •  
Child 3: Special Needs/Allergies
For your child's safety as well as helping us to best meet your child's needs, please note any special needs, concerns (learning, behavior, or health) and allergies. You may also send any procedure plans to Religious Education Office, if needed.
Please list any special needs or concerns
  •  
Please reply N/A, if not applicable
Please list ANY FOOD or DRINK ALLERGIES
  •  
N/A, if not applicable
Please indicate your preference for this child consuming food/drink during class.
  •  
Please do NOT allow my child to eat/drink the following
  •  
Child 4: Information
Grade Child 4 to enter in Religious Education 2019
  •  
Child 4:Name
  •  
Child 4: Nickname/Preferred Name
  •  
Child 4: Gender
  •  
Child 4: Birthdate //
  •  
Child 4: Place of Birth
  •  
School Attending in the Fall of 2019
  •  
School Grade in the Fall 2019
  •  
Did this child attend RE classes or Catholic School last year?
  •  
If yes, where did he/she attend?
  •  
What Grade in RE or Catholic School did he/she attend last year?
  •  
Child 4: Sacramental Information
This sections if for NEW or TRANSFER students only. Note:A copy of child's baptismal certificate is required for any student not baptized at St. Joseph Parish.
This child has received the following sacraments
  •  
Date and Church of Baptism (Include City, State)
  •  
Date and Church of First Communion (Include City, State)
  •  
Child 4: Special Needs/Allergies
or your child's safety as well as helping us to best meet your child's needs, please note any special needs, concerns (learning, behavior, or health) and allergies. You may also send any procedure plans to Religious Education Office, if needed.
Please list any special needs or concerns
  •  
Please type N/A, if not applicable
Please list any FOOD or DRINK ALLERGIES
  •  
N/A, if not applicable
Please indicate your preference for this child consuming food/drink during RE Sessions
  •  
Please do NOT allow my child to eat/drink the following
  •  
Medical Permission Form
I grant permission for the administration of First Aid to my child by the people in charge of St. Joseph Religious Education Program as their judgment deems advisable, and to make the necessary referrals to qualified physicians for treatment of illness or accidents of a more serious nature. I understand I will be promptly notified in the event of any serious illness or accident and prior to any major surgery, except when delay in such communication would endanger life. In case of medical emergency, I understand that every effort will be made to contact the parent/guardian of the student. In the event that I cannot be reached, I hereby give permission to the physicians selected by the adult staff to hospitalize, secure proper treatment for, and to order injection, anesthesia or surgery if deemed necessary for my child.
Medical Permission
  •  
Insurance Information
  •  
Insurance Company
  •  
Policy Number
  •  
Insurance Phone -- ext
  •  
Authorized Physician
  •  
Authorized Physician's Phone -- ext
  •  
Preferred Hospital
  •  
Please enter your legal name as parent or guardian for digital signature
  •  
Today's Date //
  •  
Emergency Contact Information
Please provide someone OTHER THAN a parent. This person will be contacted in the event that a parent cannot be reached.
Name
  •  
Relationship to the Child(ren)
  •  
Emergency Contact Phone -- ext
  •  
CHILD 1: MEDICAL and ALLERGY INFORMATION
Please complete medical and allergy information for EACH CHILD
Child 1: Name
  •  
Child 1: Birthdate //
  •  
Child 1: Allergic to Medication
  •  
If Yes, Please list/describe
  •  
Child 1: Current Medications
  •  
CHILD 2: MEDICAL and ALLERGY INFORMATION
Child 2:Name
  •  
Child 2: Birthdate //
  •  
Allergic to Medication
  •  
If Yes, please list/describe
  •  
N/A, if not applicable
Child 2: Current Medications
  •  
N/A, if not applicable
CHILD 3: MEDICAL and ALLERGY INFORMATION
Child 3: Name
  •  
Child 3: Birthdate //
  •  
Child 3: Allergic to medication
  •  
If Yes, please list/describe
  •  
Current Medication
  •  
CHILD 4: MEDICAL and ALLERGY INFORMATION
Child 4: Name
  •  
Child 4: Birthdate //
  •  
Child 4: Allergic to Medication
  •  
If Yes, please list/describe
  •  
Child 4: Current Medications
  •  
General and Medical Permission
General Permission
  •  
I request that my child(ren) listed above, be allowed to participate in the St. Joseph Parish Religious Education Program, located at/in St. Joseph Parish, Bradley, IL on the following days(s): the scheduled Wednesday’s from 4:30-5:45 or for Jr. High Sacraments class the scheduled Sundays from 9:30am -12:00 from September 2018 –May 2020.
Videotaping and Photographs
  •  
In regard to St Joseph RE program publishing my child's/children's personally identifiable image and work in places and via electronic, auditory, print and any other media accessible by the public (including said parish, diocese, bulletins, newspapers, web sites and other print publications).
Parent/Guardian Acknowledgement
  •  
All families who register for Religious Education, please indicate that you have reviewed the following documents located on the St. Joseph Parish Website Religious Education home page.
Signed up for REMIND
  •  
Please be sure to click on the "Sign up for Remind App" link located on the RE Homepage, so that you can receive emergency announcements and brief reminders.
Please Read: “The parties agree that this document may be electronically signed and that the electronic signature appearing on this document is the same as handwritten signatures for the purpose of validity, enforceability and admissibility.” “Transmission via email is not encrypted, so if you are concerned about the security of your sensitive information, please print and fax this form, surface mail it or hand deliver it.”
Please enter your legal name as parent or guardian for digital signature
  •  
Today's Date //
  •  
Spam Capture
  •