Religious Education Registration Form

Name

This field is for validation purposes and should be left unchanged.

(For Children K – 8, Confirmation Class Sunday only) Which day will your child attend the program?(Required)

Fee: $50 for the first child, $45 for the second, $40 for the third, and the fourth child is free.

Please drop off cash or check labeled “Religious Education 2026-2027” in a collection basket, at the Parish Office, or at the Religious Education Office.

Name of Student:(Required)

First Middle Initial Last

If your child prefers to be called by a nickname, please list it here:

Gender:(Required)

Male

Female

Grade in School:(Required)

Contact Information

Please be advised that we’ll use this information to reach out to you with important program updates. It is imperative that you provide us with a working email and phone number. If there is a change in this information, please notify us immediately.

We kindly ask that you answer calls from 860-582-2888, as these are from the Office of Religious Education and contain important information.

Address:(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Best Phone Number:(Required)

Additional Number:

E-mail Address:(Required)

Family Information: (Please use legal names, as these are used when completing Sacramental Records.)

Mother's Name:(Required)

Cell Number:(Required)

Mother's Maiden Name:(Required)

Father's Name:(Required)

Cell Number:(Required)

Family Status:(Required)

Child living with both parents

Child living with one parent

If child living with one parent select:

Mother

Father

Sacramental Information

(Please note: A copy of your child’s Baptismal certificate must be on file in the Religious Education Office. If your child needs to be baptized, please notify the Director of Religious Education, Ms. Grace Lutfy by phone or email.)

Date of Birth:(Required)

Place of Birth:(Required)

Baptism Date:(Required)

Place of Baptism:(Required)

Baptismal certificate:

Max. file size: 200 MB.

Date of first Reconciliation:

Place of First Reconciliation:

First Holy Communion Date

Place of First Holy Communion:

Emergency Contacts

Please provide contacts in case parents cannot be reached in an emergency.

Name:(Required)

Phone:(Required)

Relationship:(Required)

Name(Required)

Phone:(Required)

Relationship:(Required)

Is your family a parishioner of St. Joseph?

Yes

Please list allergies and any medical/behavioral information we should be aware of, type NONE if there aren't any.(Required)

Consent to take photos/videos:(Required)

Yes

Consent to use photos/videos taken of your child in class for publicity, promotional, or educational purposes:(Required)

Yes

Permission for medical care:(Required)

Yes

Any other information we should know?

Signature of Parent or Legal Guardian(Required)