Religious Education Registration Form

IMPORTANT: Please complete this form in full with one exception…For new students enrolling in Sacramental Preparation programs, you must complete the “Sacramental Information” below and provide a copy of your baptism certificate by your first class date. If you are a returning student, you do not need to complete the Sacramental Information. If there is a fee for your class, you will be invoiced. Detailed information regarding each program, along with fees, can be found on the St. Francis Xavier Religious Education Website. For questions, please email Rosie Roope

This form is for the following Parish Religious Education classes:

  • Sunday School (Pre-K & K)
  • Elementary Grades 1-5 Religious Ed & Sacramental Prep
  • Confirmation Year 1 (Registration Closed - To be placed on a waiting list, email: Rosie Roope)
  • Adult Confirmation (3 R's)
  • RCIA for Adults & Children over the age of 7 (Becoming Catholic).

Student Information

*Student's First Name:
Student's Middle Name:
*Student's Last Name:
Any Nicknames?:
Family Email Viewed Most Often:
If in Confirmation, Teen's Email:
*ZIP Code
Birth Date:
Home Phone:
Cell Phone:
Are you a current registered parishioner? Yes No Your Parish
School Attending:
Grade in the Fall:

Family Information

Adults, if you are registering yourself in preparation of Baptism, Communion or Confirmation, please be sure to fill out parent information as well.

Mother's Full Name:
Mother's Maiden Name:
Mother's Cell Phone:
Mother's Religion:
Father's Full Name:
Father's Cell Phone:
Father's Religion:
Lives with:
If other, please specify name, relationship & contact phone:

Sacramental Information

New incoming students enrolling for sacramental preparation, please be sure to provide a copy of your baptism certificate to our office by the first class date.

Has the student ever been Baptized?
Church of Baptism (full name):
Date of Baptism:
Full Address of Church:
Has the student received Holy Communion?
Church of Holy Communion:
Date of Communion:
Address of Church:
Has the student been Confirmed?
Church where Confirmed:
Date of Confirmation:
Address of Church:

Emergency Contact & Medical Information

If student is under 18, please list those (other than parents/guardians) who will be dropping off and/or picking the student up from classes.

Full Name:
Emergency Contact Full Name:
Phone Number:
Doctor's Name:
Doctor's Phone:
Does the student have any allergies (medications, foods, etc)?
 No Yes Unk If YES, please explain in detail:
Does the student have any medical concerns or special needs, including medications being used?
 No Yes If YES, please explain in detail:

Saint Francis Xavier welcomes you to our community and we appreciate the time you took to fill out our application. Please double check the application for any errors and when complete, click the SUBMIT button below.

Please Prove You're Human: