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Register for PSR

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We are happy you are enrolling your child(ren) in our Parish School of Religion this year. Please submit the following information to successfully register for PSR. You may also include payment with your registration. Payment is $65 / child, with a $125 maximum / family. Payment is due in full by Sunday, October 8, 2017. For more information, please visit our PSR page.
The maximum number of form submissions has been reached. This form is currently not available.
- Are you a registered parishioner of Ss. Robert & William REQUIRED Yes No Please fill out this field.
- How many children are you registering? REQUIRED Please fill out this field.
  
  Child 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.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Place of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism Date
  Please supply a copy of baptism certificate if from another parish
  Please enter a date.
  
  First Communion Date
  If applicable
  Please enter a date.
  
  First Communion Church
  If applicable
  Please enter valid data.
  
  Has this child received the Sacrament of Reconciliation? REQUIRED Please fill out this field.
  
  School Attending REQUIRED Please fill out this field. Please enter valid data.
  
  Current Grade Level REQUIRED Please fill out this field.
  
  Street Address 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.
  
  Father's Full Name REQUIRED Please fill out this field. Please enter valid data.
  
  Father's Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Father's Cell Phone REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Full Name REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Cell Phone REQUIRED Please fill out this field. Please enter valid data.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Child lives with: REQUIRED
  This information helps our catechists be sensitive to the student's home life and needs.
  Please fill out this field.
  
  Are there any psychological or educational concerns, family situations, or custody arrangements that we need to be made aware of?
  
  Previous Religious Education: REQUIRED Please fill out this field.
  
  Last parish of religious education:
  If applicable
  Please enter valid data.
  
  Medical, physical conditions, special needs, or food allergies?
  
  Child 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.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Place of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism Date
  Please supply a copy of baptism certificate if from another parish
  Please enter a date.
  
  First Communion Date
  If applicable
  Please enter a date.
  
  First Communion Church
  If applicable
  Please enter valid data.
  
  Has this child received the Sacrament of Reconciliation? REQUIRED Please fill out this field.
  
  School Attending REQUIRED Please fill out this field. Please enter valid data.
  
  Current Grade Level REQUIRED Please fill out this field.
  
  Street Address 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.
  
  Father's Full Name REQUIRED Please fill out this field. Please enter valid data.
  
  Father's Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Father's Cell Phone REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Full Name REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Cell Phone REQUIRED Please fill out this field. Please enter valid data.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Child lives with: REQUIRED
  This information helps our catechists be sensitive to the student's home life and needs.
  Please fill out this field.
  
  Are there any psychological or educational concerns, family situations, or custody arrangements that we need to be made aware of?
  
  Previous Religious Education: REQUIRED Please fill out this field.
  
  Last parish of religious education:
  If applicable
  Please enter valid data.
  
  Medical, physical conditions, special needs, or food allergies?
  
  Child 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.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Place of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism Date
  Please supply a copy of baptism certificate if from another parish
  Please enter a date.
  
  First Communion Date
  If applicable
  Please enter a date.
  
  First Communion Church
  If applicable
  Please enter valid data.
  
  Has this child received the Sacrament of Reconciliation? REQUIRED Please fill out this field.
  
  School Attending REQUIRED Please fill out this field. Please enter valid data.
  
  Current Grade Level REQUIRED Please fill out this field.
  
  Street Address 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.
  
  Father's Full Name REQUIRED Please fill out this field. Please enter valid data.
  
  Father's Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Father's Cell Phone REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Full Name REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Cell Phone REQUIRED Please fill out this field. Please enter valid data.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Child lives with: REQUIRED
  This information helps our catechists be sensitive to the student's home life and needs.
  Please fill out this field.
  
  Are there any psychological or educational concerns, family situations, or custody arrangements that we need to be made aware of?
  
  Previous Religious Education: REQUIRED Please fill out this field.
  
  Last parish of religious education:
  If applicable
  Please enter valid data.
  
  Medical, physical conditions, special needs, or food allergies?
  
  Child 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.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Place of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism Date
  Please supply a copy of baptism certificate if from another parish
  Please enter a date.
  
  First Communion Date
  If applicable
  Please enter a date.
  
  First Communion Church
  If applicable
  Please enter valid data.
  
  Has this child received the Sacrament of Reconciliation? REQUIRED Please fill out this field.
  
  School Attending REQUIRED Please fill out this field. Please enter valid data.
  
  Current Grade Level REQUIRED Please fill out this field.
  
  Street Address 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.
  
  Father's Full Name REQUIRED Please fill out this field. Please enter valid data.
  
  Father's Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Father's Cell Phone REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Full Name REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Cell Phone REQUIRED Please fill out this field. Please enter valid data.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Child lives with: REQUIRED
  This information helps our catechists be sensitive to the student's home life and needs.
  Please fill out this field.
  
  Are there any psychological or educational concerns, family situations, or custody arrangements that we need to be made aware of?
  
  Previous Religious Education: REQUIRED Please fill out this field.
  
  Last parish of religious education:
  If applicable
  Please enter valid data.
  
  Medical, physical conditions, special needs, or food allergies?
  
  Child 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.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Place of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism Date
  Please supply a copy of baptism certificate if from another parish
  Please enter a date.
  
  First Communion Date
  If applicable
  Please enter a date.
  
  First Communion Church
  If applicable
  Please enter valid data.
  
  Has this child received the Sacrament of Reconciliation? REQUIRED Please fill out this field.
  
  School Attending REQUIRED Please fill out this field. Please enter valid data.
  
  Current Grade Level REQUIRED Please fill out this field.
  
  Street Address 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.
  
  Father's Full Name REQUIRED Please fill out this field. Please enter valid data.
  
  Father's Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Father's Cell Phone REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Full Name REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Cell Phone REQUIRED Please fill out this field. Please enter valid data.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Child lives with: REQUIRED
  This information helps our catechists be sensitive to the student's home life and needs.
  Please fill out this field.
  
  Are there any psychological or educational concerns, family situations, or custody arrangements that we need to be made aware of?
  
  Previous Religious Education: REQUIRED Please fill out this field.
  
  Last parish of religious education:
  If applicable
  Please enter valid data.
  
  Medical, physical conditions, special needs, or food allergies?
  
  Child 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.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Place of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism Date
  Please supply a copy of baptism certificate if from another parish
  Please enter a date.
  
  First Communion Date
  If applicable
  Please enter a date.
  
  First Communion Church
  If applicable
  Please enter valid data.
  
  Has this child received the Sacrament of Reconciliation? REQUIRED Please fill out this field.
  
  School Attending REQUIRED Please fill out this field. Please enter valid data.
  
  Current Grade Level REQUIRED Please fill out this field.
  
  Street Address 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.
  
  Father's Full Name REQUIRED Please fill out this field. Please enter valid data.
  
  Father's Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Father's Cell Phone REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Full Name REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Cell Phone REQUIRED Please fill out this field. Please enter valid data.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Child lives with: REQUIRED
  This information helps our catechists be sensitive to the student's home life and needs.
  Please fill out this field.
  
  Are there any psychological or educational concerns, family situations, or custody arrangements that we need to be made aware of?
  
  Previous Religious Education: REQUIRED Please fill out this field.
  
  Last parish of religious education:
  If applicable
  Please enter valid data.
  
  Medical, physical conditions, special needs, or food allergies?
- Photo Consent
  
  I (we) the parent(s) and/or guardians of my (our) minor (child)ren do hereby consent and authorize the release, publication, dissemination, distribution, use, and/or reproduction of any and all photographs taken of my(our) daughter(s)/son(s) during his/her enrollment at SS Robert & William Parish School of Religion by an employee, agent or representative of SS Robert & William Parish School of Religion or an independent contractor.
  
  This Release and Authorization acknowledges that all photographic proofs, photographic negatives, positives and prints shall constitute the property of SS Robert & William Parish School of Religion and may be used by SS Robert & William Parish School of Religion for any purpose determined at its discretion without further notice or any compensation to me or to my daughter(s)/son(s).
  
  Photo Release Consent REQUIRED I Agree to the Photo Release Terms I Do Not Agree to the Photo Release Terms Please fill out this field.
  
  Name of parent/guardian granting consent REQUIRED Please fill out this field. Please enter valid data.
- Emergency Medical Contact
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Relationship to family REQUIRED Please fill out this field. Please enter valid data.
  
  Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Secondary Number Please enter a phone number.
- How many children are you registering for PSR? REQUIRED
  Please select a number. You have the option to pay later.
  Please fill out this field.
Total:

Submit

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