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St. Pius X Religious Formation Re-Registration
Please use this form for any child who has previously been registered for St. Pius X Religious Formation.
If you are registering more than 4 children, please contact Kurt Kilanowski at the Ministry House - dre@st-pius-x.org
Family Name
*
Address
*
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Home Phone
###
-
###
-
####
Primary Email Address
*
Secondary Email Address (optional)
Father's Full Name
First
Last
Father's Phone
###
-
###
-
####
Mother's Full Name
First
Last
Mother's Phone
###
-
###
-
####
Emergency Contact
First
Last
Emergency Contact Phone
###
-
###
-
####
Statement of Faith Commitment
*
I understand I am registering my child(ren) to attend Mass and class as part of their religious formation.
Attendance Policy
*
I understand that all missed content must be made up.
Child Info
Child's Name
First
Last
School
Grade in School 2022-2023
Please select
K
1
2
3
4
5
6
7
8
Gender
Male
Female
Birthdate
MM
/
DD
/
YYYY
Catechist Name
Please tell us about any medical or learning concerns.
Do you wish to have an additional mailing for this child sent (i.e. father or mother living in an additional household)?
Please select
Yes
No
Name
First
Last
Relationship
Email
Address
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Would you like to register another child?
Please select
Yes
No
If you are registering one child only, this form will automatically submit when you click "next" below.
1
/
4
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