2021-2022 PSR/Youth Group Registration
Register today so we can successfully plan for the year!
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Email *
Parent Last Name: *
Parent(s) First Name(s): *
Parent Contact Phone Number: *
Additional Parent Contact Phone Number:
Home Address: *
Emergency Contact Name (other than Parents): *
Emergency Contact Phone Number: *
Child #1 LAST Name (please begin with youngest child you are enrolling): *
Child #1 FIRST Name (please begin with youngest child you are enrolling): *
Child #1 Grade, Fall of 2021 *
Child #2 LAST Name:
Child #2 FIRST Name:
Child #2 Grade, Fall of 2021:
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Child #3 LAST Name:
Child #3 FIRST Name:
Child #3 Grade, Fall of 2021:
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Child #4 LAST Name:
Child #4 FIRST Name:
Child #4 Grade, Fall of 2021:
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Additional Children and Grade Levels:
If your teen (7-12) has a cell phone number, please list name and number here.  This will only be used through Group Me app for invitations and reminders.
Do any of your children have specific needs or allergies? *
Do any of your children need to be baptized? *
Will your child receive First Communion this year? (Please email Ellen at eschmitz.coa@gmail.com or call 628-5030 if you need clarification.  Child must be 2nd grade or older.)
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Will your child be in the Confirmation Program? (This is a two-part process, typically beginning Sophomore year).
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Last year we offered virtual learning for K-12.  Is this something you would be interested in this year? *
Every year our diocese uses a personal safety curriculum called Circle of Grace.  This program teaches skills that will help keep them safe from dangerous or abusive situations.  Children also learn to ask for help when needed.  Do you give permission for your child(ren) to participate in Circle of Grace? *
Do you give permission for your child(ren) to be photographed for bulletin, Church of the Annunciation website and/or Church of the Annunciation Facebook page? *
I give permission for my child(ren) to participate in Church of the Annunciation's Parish School of Religion/Youth Ministry program.  In giving my permission, I understand there is a risk of injury to my child.  Should my child sustain injury while participating in the Parish School of Religion and Youth Ministry program, I promise not to hold the supervisors of the activity or facility of the Church of the Annunciation responsible.  At this time, our parish does not require that masks be worn during Mass, classes or activities.  By signing this you will acknowledge the following:  I acknowledge that the requirements concerning masks may change anytime due to diocesan regulations.  I acknowledge that it is my responsibility to monitor the health of my child before coming and will not send my child to a parish event if he/she has Covid-19 or is in quarantine as a precautionary measure.   I understand that the Church of the Annunciation has implemented preventative measures, but cannot guarantee that one will not be exposed to, contact or spread Covid-19.  Therefore I acknowledge this risk and will not hold Church of the Annunciation liable.  Please type your name below if you agree. *
Fees to cover program expenses are $40 per child.  ($75 for 2 children, $110 for 3 children, $145 for 4 children).  Additionally, there is a Sacrament fee of $50 for First Communion children and each part of Confirmation prep. Scholarships are available; please contact the church office if you need financial assistance.  How do you plan to pay for registration fees? *
PSR is always looking for enthusiastic teachers and substitute teachers.  Please indicate below if you would be interested:
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