| St. Patrick Catholic Church

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- Registration Form PK-12
  
  Thank you for signing-up for our spKids and spStudents Programs.
- The maximum number of form submissions has been reached. This form is currently not available.
  
  Family Name REQUIRED Please fill out this field. Please enter valid data.
  
  Home Phone REQUIRED Please fill out this field. Please enter valid data.
  
  Street Address REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Email REQUIRED Please fill out this field. Please enter valid data.
  
  Father's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Father's Cell REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Name + Maiden Name REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Cell REQUIRED Please fill out this field. Please enter valid data.
  
  Emergency Contact REQUIRED Please fill out this field. Please enter valid data.
  
  Emergency Contact Name REQUIRED Please fill out this field. Please enter valid data.
  
  Emergency Contact Cell REQUIRED Please fill out this field. Please enter valid data.
  
  Relationship to Child Please enter valid data.
  
  Children REQUIRED Please fill out this field.
  
  Child 1
  
  Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birthdate REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism Date, Church, Town, State REQUIRED Please fill out this field. Please enter valid data.
  
  Male/Female REQUIRED Please fill out this field. Please enter valid data.
  
  School Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade / Sacramental Prep REQUIRED Please fill out this field.
  
  What food allergies does your child have? REQUIRED Please fill out this field. Please enter valid data.
  
  Does your child carry an EpiPen? REQUIRED Please fill out this field. Please enter valid data.
  
  Is there anything we need to know to make your child successful in Faith Formation?
  
  Child 2
  
  Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birthdate REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism Date, Church, Town, State REQUIRED Please fill out this field. Please enter valid data.
  
  Male/Female REQUIRED Please fill out this field. Please enter valid data.
  
  School Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade / Sacramental Prep REQUIRED Please fill out this field.
  
  What food allergies does your child have? REQUIRED Please fill out this field. Please enter valid data.
  
  Does your child carry an EpiPen? REQUIRED Please fill out this field. Please enter valid data.
  
  Is there anything we need to know to make your child successful in Faith Formation?
  
  Child 3
  
  Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birthdate REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism Date, Church, Town, State REQUIRED Please fill out this field. Please enter valid data.
  
  Male/Female REQUIRED Please fill out this field. Please enter valid data.
  
  School Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade / Sacramental Prep REQUIRED Please fill out this field.
  
  What food allergies does your child have? REQUIRED Please fill out this field. Please enter valid data.
  
  Does your child carry an EpiPen? REQUIRED Please fill out this field. Please enter valid data.
  
  Is there anything we need to know to make your child successful in Faith Formation?
  
  Child 4
  
  Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birthdate REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism Date, Church, Town, State REQUIRED Please fill out this field. Please enter valid data.
  
  Male/Female REQUIRED Please fill out this field. Please enter valid data.
  
  School Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade / Sacramental Prep REQUIRED Please fill out this field.
  
  What food allergies does your child have? REQUIRED Please fill out this field. Please enter valid data.
  
  Does your child carry an EpiPen? REQUIRED Please fill out this field. Please enter valid data.
  
  Is there anything we need to know to make your child successful in Faith Formation?
  
  Child 5
  
  Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birthdate REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism Date, Church, Town, State REQUIRED Please fill out this field. Please enter valid data.
  
  Male/Female REQUIRED Please fill out this field. Please enter valid data.
  
  School Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade / Sacramental Prep REQUIRED Please fill out this field.
  
  What food allergies does your child have? REQUIRED Please fill out this field. Please enter valid data.
  
  Does your child carry an EpiPen? REQUIRED Please fill out this field. Please enter valid data.
  
  Is there anything we need to know to make your child successful in Faith Formation?
  
  Child 6
  
  Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birthdate REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism Date, Church, Town, State REQUIRED Please fill out this field. Please enter valid data.
  
  Male/Female REQUIRED Please fill out this field. Please enter valid data.
  
  School Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade / Sacramental Prep REQUIRED Please fill out this field.
  
  What food allergies does your child have? REQUIRED Please fill out this field. Please enter valid data.
  
  Does your child carry an EpiPen? REQUIRED Please fill out this field. Please enter valid data.
  
  Is there anything we need to know to make your child successful in Faith Formation?
  
  Child 7
  
  Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birthdate REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism Date, Church, Town, State REQUIRED Please fill out this field. Please enter valid data.
  
  Male/Female REQUIRED Please fill out this field. Please enter valid data.
  
  School Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade / Sacramental Prep REQUIRED Please fill out this field.
  
  What food allergies does your child have? REQUIRED Please fill out this field. Please enter valid data.
  
  Does your child carry an EpiPen? REQUIRED Please fill out this field. Please enter valid data.
  
  Is there anything we need to know to make your child successful in Faith Formation?
  
  Child 8
  
  Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birthdate REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism Date, Church, Town, State REQUIRED Please fill out this field. Please enter valid data.
  
  Male/Female REQUIRED Please fill out this field. Please enter valid data.
  
  School Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade / Sacramental Prep REQUIRED Please fill out this field.
  
  What food allergies does your child have? REQUIRED Please fill out this field. Please enter valid data.
  
  Does your child carry an EpiPen? REQUIRED Please fill out this field. Please enter valid data.
  
  Is there anything we need to know to make your child successful in Faith Formation?
  
  Child 9
  
  Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birthdate REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism Date, Church, Town, State REQUIRED Please fill out this field. Please enter valid data.
  
  Male/Female REQUIRED Please fill out this field. Please enter valid data.
  
  School Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade / Sacramental Prep REQUIRED Please fill out this field.
  
  What food allergies does your child have? REQUIRED Please fill out this field. Please enter valid data.
  
  Does your child carry an EpiPen? REQUIRED Please fill out this field. Please enter valid data.
  
  Is there anything we need to know to make your child successful in Faith Formation?
  
  Child 10
  
  Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birthdate REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism Date, Church, Town, State REQUIRED Please fill out this field. Please enter valid data.
  
  Male/Female REQUIRED Please fill out this field. Please enter valid data.
  
  School Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade / Sacramental Prep REQUIRED Please fill out this field.
  
  What food allergies does your child have? REQUIRED Please fill out this field. Please enter valid data.
  
  Does your child carry an EpiPen? REQUIRED Please fill out this field. Please enter valid data.
  
  Is there anything we need to know to make your child successful in Faith Formation?
  
  Payment Method REQUIRED Please fill out this field.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Thank you for your registration.
  Aileen Lemoine.
  
  Submit
  
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- Dear Parent or Guardian,
  
  This year 2020/21, at St. Patrick's we are holding virtual sessions for all grades with the exception of Grades 2 and 11. Grades 2 and 11 will meet outside while the weather is good. The most important concern for us is SAFTEY for your child and your family. If you have any questions please, email Aileen at aileen@mystpatricks.com
  
  If you are enrolling your child in grades 2 or 11, we must have a copy of your child's Baptismal Certificate on record unless your child was baptized at St. Patrick's, than you are all set.
  
  Tuition: To pay with cash or check you can pay at the rectory in person of via mail. Payment Plan is available as well.
  
  We accept electronic payment for your convenience.
  
  Preschool and Kindergarten: $45.00 per child
  
  Sacramental Prep (Grades 2 and 11): $105.00 per child
  
  Other: $65.00 per child
  
  PAY ONLINE
  Thank you and God Bless,
  Aileen Lemoine

Registration Form PK-12

PAY ONLINE