<p> Fourteen Holy Helpers Religious Education REGISTRATION FORM 2014-2015 PLEASE PRINT CLEARLY: Please check: _____ Reg. Program _____ Summer Program (Grades 6-10) _____ 9 & 10 Grade Catholic School Student (Summer Program Form also needs to be filled out)</p><p>Father’s Name ______Mother’s Name ______First Last First Last Maiden Name Married _____Widow _____Divorced _____Single_____ Step-Parent’s Name if applicable ______</p><p>Address: ______Street City Zip Code Tele. # ______Cell # ______Is your family registered in the Parish? ______If no, what church are you registered at ______Yes No Father’s Religion ______Father’s Email______Who does child reside with? ______Mother’s Religion ______Mother’s Email______Mom Dad Both</p><p>NAMES OF STUDENTS TO BE ENROLLED First and Last Name Birth Date Grade (Rel. Ed.) School Attending MM/DD/YY In Sept. 2014 In Sept. 2014 1.______</p><p>2.______</p><p>3.______</p><p>4.______</p><p>PLEASE COMPLETE FOR EACH CHILD:</p><p>BAPTIZED -CHURCH (City, State) /DATE 1ST PENANCE- CHURCH (City, State) /DATE 1ST COMMUNION- CHURCH (City, State) /DATE </p><p>1.______</p><p>2.______</p><p>3.______</p><p>4.______WE MUST HAVE A COPY OF THE BAPTISMAL CERTIFICATE FOR ALL 1 ST GRADERS AND ANY NEW STUDENTS ENTERING FOURTEEN HOLY HELPERS REL. ED. PROGRAM We also need a copy of Penance & Communion certificates, if your child has received the Sacraments.</p><p>If your child has any special needs (educational/medical/food allergies), please let us know. Smaller classes are offered if your child requires a small environment/class.</p><p>Child’s Name </p><p>Emergency Contact Number DURING School Hours: ______Name Tele. # ***NEW STUDENTS ONLY*** Please fill out for each child, the parish attended and year for each grade. Grades Child (1) Child (2) Child (3) Child (4) Parish/ Year Parish/ Year Parish/ Year Parish/ Year 1 st 2 nd 3 rd 4 th 5 th 6 th 7 th 8 th 9 th </p><p>We will need proof of Religious Education received to date!</p><p>Regular Program: REGISTRATION FEES: Due by Friday, JUNE 14th Grades 1-8---$50.00 per child *PLUS* $20.00 Sacramental Fees for Grades 2 & 3. 9th Grade Public School Students: $50.00 9th Grade CATHOLIC School Students: No Charge—But MUST REGISTER!!! 10th Grade Catholic School Students: $50.00 Fee 10th Grade Public School Students: $50.00 Plus $25.00 Sacramental Fee—TOTAL--$75 .00</p><p>Summer Program: REGISTRATION AND FEE: Due by Friday, MAY 10th Grades 6-9 $55.00 per child 10th Grade Students: $55.00 Plus $25.00 Sacramental Fee—TOTAL--$80.00</p><p>Non-Parishioners: REGISTRATION FEES: Due by Friday, JUNE 14th Grades 1-8---$85.00 per child *PLUS* $25.00 Sacramental Fees for Grades 2 & 3. 9th Grade Public School Students: $85.00 9th Grade CATHOLIC School Students: $50.00 10th Grade Catholic School Students: $85.00 Fee 10th Grade Public School Students: $85.00 Plus $35.00 Sacramental Fee—TOTAL--$120.00</p><p>THERE WILL BE AN ADDITIONAL CHARGE OF $25 FOR ALL REGISTRATIONS NOT PAID BY JUNE 14, 2014 THERE WILL BE NO REFUNDS ON REGISTRATION FEES NO Exceptions!!!! For Office use only</p><p>Date Reg. ______-______-______Amount Paid $______Date Paid ______-______-______</p><p>Check # ______Reg. By: ______Late Fee Paid Date ______-______-______</p>