Corpus Christi - St. Bernard Parish

Religious Education Registration

1529 Washington St, Newton, MA 02465

Date:

Parents names: Home Phone:

Address: Mom/Dad Cell: M D

M. Maiden: Emerg. Phone:

Email:

Custodial Parent, if different from above:

Rel Ed mailing to additional address? If so, enter here:

Child Birth date Gender Grade Session School attending Sept. 10:

Sacrament/Date/Location: Baptism Eucharist Eucharist needed?:

Confirmation needed?:

Special Needs: medical, learning disabilities, physical disabilities:

Child Birth date Gender Grade Session School attending Sept. 10

Sacrament/Date/Location: Baptism Eucharist Eucharist needed?:

Confirmation needed?:

Special Needs: medical, learning disabilities, physical disabilities:

Child Birth date Gender Grade Session School attending Sept. 10:

Sacrament/Date/Location: Baptism Eucharist Eucharist needed?:

Confirmation needed?:

Special Needs: medical, learning disabilities, physical disabilities:

Child Birth date Gender Grade Session School attending Sept. 10:

Sacrament/Date/Location: Baptism Eucharist Eucharist needed?:

Confirmation needed?:

Special Needs: medical, learning disabilities, physical disabilities:

NOTE: If any of your children were baptized outside of this parish, and you have not already supplied us with a copy of

each child's baptismal record, you will need to supply a copy for our files.

Tuition due: $_____________ Tuition Pd: $_____________ Signature: