Catechesis of the Good Shepherd Registration Form

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Atrium Registration 2023-2024

Email *

Please choose the class for your child: *

Level 1 Atrium (3 - 6 year old children - PK through Kindergarten) *must be potty-trained; must turn 3 no later than Aug. 1, 2023

Level 2 Atrium (rising 1st grade - 6 year old)

Child's Name *

Child's Date of Birth *

YYYY

Family Address *

Parents' Names *

Mom's Email *

Dad's Email *

Parents' Phone Numbers (or best contact #) *

In case of emergency contact person name & number *

Preferred Hospital (based on insurance) *

Health concerns (allergies) or special needs *

Members of St. Louis Church Parish *

Yes

Media Release Permission...Photo Release Agreement: Permission is given for the above named child to be photographed or videotaped at St. Louis Church Catechesis of the Good Shepherd or any Diocesan event. I realize that the photos may be published in the newspaper, a magazine, church website, church Facebook page, or other publication for educational or informational purposes regarding the programs or curriculum at the church or in the Diocese. *

Yes I agree to the media release

No I do not agree to the media release

Payment Information: Cost $70 per child/$100 for two children/$125 max family (payments based off students enrolled in CGS and PRE)

Please go to the church website stlouischurchmphs.org to submit your payment using the provided instructions:

1. Click on ONLINE GIVING
2. Login or set up an account
3. Scroll down to OTHER and choose RELIGIOUS EDUCATION
4. Submit payment via ACH only (NO credit cards or debit cards; payment made through checking or savings acct. only)
5. If you have already made a payment for older sibling(s) enrolled in PRE, please just make pay the difference based on the information above...ex: 1 child PRE 2nd grade already paid $70 + 1 child CGS = new payment due $30)

*Registration is not complete without submitting this form and making your payment. If you prefer, you may turn in cash or a check to the church office. Please make checks out to St. Louis Church and note for CGS...THANK YOU!

A copy of your responses will be emailed to the address you provided.

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