Late Religious Education Enrollment

Sign Up

Through July 16: 1 Child = $95/ 2 or more children = $175
July17-August 15: 1 Child = $105/ 2 or more children = $190
After August 16: 1 Child = $120/ 2 or more children = $210

Additional $20 will be added after September 2nd

Refunds will not be given after 8/15/23.
If withdrawing before 8/15, $50 will be withheld to cover costs for materials and fees already paid for.

Who is filling out this form? REQUIRED Please fill out this field.

If "Other" please specify: Please enter valid data.

Number of Children on this form: REQUIRED Please fill out this field.

Volunteering at Religious Education I would like to help as an aide

Are you filling out this form after Sept. 2nd? REQUIRED

Please note that after Sept. 2nd there is a $20 late charge

Please fill out this field.

Parent/ Guardian 1 Informatin:

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Email REQUIRED Please fill out this field. Please enter an email address.

Emergency Contact: REQUIRED Please fill out this field. Please enter valid data.

Child's relation to emergency contact: REQUIRED Please fill out this field. Please enter valid data.

Emergency Contact Phone Number: REQUIRED Please fill out this field. Please enter valid data.

Parent/Gaurdian #2

Who else is responsible for the child/children?

Street Address Please enter valid data.

First Name Please enter valid data.

Last Name Please enter valid data.

City Please enter valid data.

State

Zip Please enter a zip code.

Email Please enter an email address.

Phone Number Please enter a phone number.

Religion Please enter valid data.

Child 1 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.

Grade entering in the fall: REQUIRED Please fill out this field.

Health Information that we need to be aware of (allergies, special classroom needs, etc.): REQUIRED Please fill out this field.

Date of Baptism REQUIRED Please fill out this field. Please enter valid data.

Place of Baptism (Church, Street Address, City, State, Zip) REQUIRED Please fill out this field.

Received 1st Eucharist: REQUIRED Yes No Please fill out this field.

Place of 1st Eucharist (if applicable)

Sacrament Registration

60.0 – 1st Eucharist & 1st Reconciliation

Child 2 Information

First Name Please enter valid data.

Last Name Please enter valid data.

Grade entering in the fall:

Health Information that we need to be aware of (allergies, special classroom needs, etc.): REQUIRED Please fill out this field.

Date of Baptism Please enter valid data.

Place of Baptism (Church, Street Address, City, State, Zip)

Received 1st Eucharist: Yes No

Place of 1st Eucharist (if applicable)

Sacrament Registration

60.0 – 1st Eucharist & 1st Reconciliation

Child 3 Information

First Name Please enter valid data.

Last Name Please enter valid data.

Grade entering in the fall:

Health Information that we need to be aware of (allergies, special classroom needs, etc.):

Date of Baptism Please enter valid data.

Place of Baptism (Church, Street Address, City, State, Zip)

Received 1st Eucharist: Yes No

Place of 1st Eucharist (if applicable)

Sacrament Registration

60.0 – 1st Eucharist & 1st Reconciliation

Child 4 Information

First Name Please enter valid data.

Last Name Please enter valid data.

Grade entering in the fall:

Health Information that we need to be aware of (allergies, special classroom needs, etc.):

Date of Baptism Please enter valid data.

Place of Baptism (Church, Street Address, City, State, Zip)

Received 1st Eucharist: Yes No

Place of 1st Eucharist (if applicable)

Sacrament Registration

60.0 – 1st Eucharist & 1st Reconciliation

If this is your first time registering for our parish religious education program, we need a copy of your child’s baptismal certificate. You may scan and email to [email protected] or mail a copy to St. Jane Frances Religious Education 8499 Virginia Ave. 21122.

In the interest of promoting and chronicling activities,St. Jane Frances often records events and activities with video, photographs, or other media. Material may be used in print, at meetings, or on the parish website or on the Parish facebook page . The security of the youth is our top priority. No personal information will ever be included in any of the material. By participating in Religious Education at St. Jane Frances, you are acknowleding that you understand.

I Agree Please select this field.

Payment must be recieved before registration is accepted in the Parish Office. If you are a Catechist, a payment page, would not come up for you since the fees are waved.

St. Jane Frances de Chantal
Catholic Church
(Pastorate parish with OLC)

8499 Virginia Ave.
Riviera Beach, Maryland 21122

www.stjane.org

Late Religious Education Enrollment

Sign Up

Through July 16: 1 Child = $95/ 2 or more children = $175
July17-August 15: 1 Child = $105/ 2 or more children = $190
After August 16: 1 Child = $120/ 2 or more children = $210

Late Religious Education Enrollment

Through July 16: 1 Child = $95/ 2 or more children = $175 July17-August 15: 1 Child = $105/ 2 or more children = $190 After August 16: 1 Child = $120/ 2 or more children = $210

Through July 16: 1 Child = $95/ 2 or more children = $175
July17-August 15: 1 Child = $105/ 2 or more children = $190
After August 16: 1 Child = $120/ 2 or more children = $210