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Child and Youth Faith Formation Registration

- Registration
  
  2024 - 2025
  
  Registration for the 2024-2025 school year is now open! All children grade 1 through 10 can register using this form.
  
  Registration Fee:
  1 student - $150
  2 students - $225
  3 students - $240
  4+ students - $260
  
  Kaethi Schommer
  Gr1-10 Faith Formation
  [email protected]
  
  Jennifer Buelow
  Director of Family Discipleship
  [email protected]
  
  Looking for Confirmation Registration? Click Here
- The maximum number of form submissions has been reached. This form is currently not available.
  
  PARENT/GUARDIAN INFORMATION
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name 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 an email address.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Are you a St. Pius X member? REQUIRED Yes No Please fill out this field.
  
  Emergency Contact
  
  Emergency Contact Name and Phone Number REQUIRED Please fill out this field.
  
  Volunteer Help!!! REQUIRED Please fill out this field.
  
  Please Enter the Number of Students REQUIRED Please fill out this field.
  
  Student 1
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade (2024-2025 School Year) REQUIRED Please fill out this field.
  
  Sex REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Allergies or Special Needs
  
  Student 2
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade (2024-2025 School Year) REQUIRED Please fill out this field.
  
  Sex REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Allergies or Special Needs
  
  Student 3
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade (2024-2025 School Year) REQUIRED Please fill out this field.
  
  Sex REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Allergies or Special Needs
  
  Student 4
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade (2024-2025 School Year) REQUIRED Please fill out this field.
  
  Sex REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Allergies or Special Needs
  
  Student 5
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade (2024-2025 School Year) REQUIRED Please fill out this field.
  
  Sex REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Allergies or Special Needs
  
  Student 6
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade (2024-2025 School Year) REQUIRED Please fill out this field.
  
  Sex REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Allergies or Special Needs
  
  Student 7
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade (2024-2025 School Year) REQUIRED Please fill out this field.
  
  Sex REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Allergies or Special Needs
  
  Student 8
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade (2024-2025 School Year) REQUIRED Please fill out this field.
  
  Sex REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Allergies or Special Needs
  
  Student 9
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade (2024-2025 School Year) REQUIRED Please fill out this field.
  
  Sex REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Allergies or Special Needs
  
  Student 10
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade (2024-2025 School Year) REQUIRED Please fill out this field.
  
  Sex REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Allergies or Special Needs
  
  Student 11
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade (2024-2025 School Year) REQUIRED Please fill out this field.
  
  Sex REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Allergies or Special Needs
  
  Student 12
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade (2024-2025 School Year) REQUIRED Please fill out this field.
  
  Sex REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Allergies or Special Needs
  
  Photo Release REQUIRED I hereby grant permission to St. Pius X to use photographs and/or video of my child(ren) in publications, news releases, online, and in other communications related to the mission of the parish. I do not grant permission to St. Pius X to publish photographs and video of my child(ren). Please fill out this field.
  
  Payment REQUIRED 150.0 – 1 Student 225.0 – 2 Students 240.0 – 3 students 260.0 – 4+ students Please fill out this field.
  
  Total:
  
  Submit
  
  Proceed to Payment
  
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