Good Shepherd Parish Religious Education
2020-2021 Program Registration
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Family Name *
Family Email Primary *
Family Email Secondary (if desired)
Phone #
Child 1's Name *
Child #1 Date of Birth & Place of Baptism
Child 1 Goes by (Nickname)
Grade for fall 2020
Child 2's Name
Child #2 Date of Birth & Place of Baptism
Child 2 Goes by (Nickname)
Grade for fall 2020
Child #3's Name
Child #1 Date of Birth & Place of Baptism
Child 3 Goes by (Nickname)
Grade for fall 2020
Add'l Info. to Help Us Support Your Children
E.g., Allergies, Learning Accommodations, etc. PLease include child's name if more than one
Religious Education Meeting Preference
Has any of your family's contact information changed or are you new to our program? *
E.g., Address, Email Address, Phone Number, Emergency Contact, Family Structure, etc.
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