2024-2025 Re-Registration Form for Current Families Re-Registration for Current Families "*" indicates required fields Step 1 of 9 11% To Switch to Spanish: Select Spanish in the Drop Down Menu in Upper Right Corner of the Website. Welcome back! We are glad you are returning to our religious education program! Re-registration is available only for children who have completed last year 2023-2024 year in our religious education program.Today's Date*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Returning Student(s) InformationHow many children will you be re-registering in Religious Education for 2024-2025?*NOTE: If you need to re-register 5 or more children in our religious education program, please do not complete this form online and contact the Religious Education coordinator. 1234 Student 1Name of Child* First Middle Last Child's Date of Birth* Month Day Year Place of Birth*(City, State, & Country) Age of Child as of September 2024*5 Years6 Years7 Years8 Years9 Years10 Years11 Years12 Years13 Years14 Years15 Years16 Years17 Years18 Years19 YearsGender* Male Female What is the name of the child's school for 2024-2025?* Please select the grade level your child is entering in Fall 2024.*Kindergarten1st2nd3rd4th5th6th7th8th9th10th11th12thMedical InformationList any medical condition or significant medical history, such as allergies or seizures, for which your child requires medication. Please state its type, frequency, and treatment.*If none, please type none.If applicable, please explain any physical limitation/disability or learning disability the student has.Sacrament InformationDid the child receive the Sacraments of.....*Baptism?First Communion?Confirmation? Add RemoveDate of Baptism Church of Baptism City and State / Country of Baptism Date of First Communion Church of First Communion City & State of First Communion If applicable, please upload child's sacramental certificates.We must have your child's certificates on file. You may also choose to bring the certificates to the religious education office. Drop files here or Select files Accepted file types: pdf, jpg, png, Max. file size: 5 MB, Max. files: 3. Class Options Session 1 Tuesday Afternoon 4:30 PM - 5:45 PM (1,2,3,4,5) Communion I and II Elementary Session 2 Tuesday Evening 6:30 PM - 7:45 PM MS (6,7,8) and HS (9,10,11,12) Confirmation I and II Session 3 Saturday Morning 9:15 AM - 10:30 AM Elementary, Communion I and II (K,1,2,3,4,5) MS (6,7,8) Confirmation I and II MS First Preference*Session 1:Tuesday AfternoonSession 2: Tuesday EveningSession 3: Saturday MorningSecond Preference*Session 1:Tuesday AfternoonSession 2: Tuesday EveningSession 3: Saturday MorningThird Preference*Session 1:Tuesday AfternoonSession 2: Tuesday EveningSession 3: Saturday Morning Student 2Name of Child* First Middle Last Child's Date of Birth* Month Day Year Place of Birth*(City, State, & Country) Age of Child as of September 2024*5 Years6 Years7 Years8 Years9 Years10 Years11 Years12 Years13 Years14 Years15 Years16 Years17 Years18 Years19 YearsGender* Male Female What is the name of the child's school for 2024-2025?* Please select the grade level your child is entering in Fall 2024.*Kindergarten1st2nd3rd4th5th6th7th8th9th10th11th12thDoes the child have any allergies? (Plants, Food, Insects, Medicine)* Yes No List any medical condition or significant medical history, such as allergies or seizures, for which your child requires medication. Please state its type, frequency, and treatment.*If applicable, please explain any physical limitation/disability or learning disability the student has.*Sacrament InformationDid the child receive the Sacraments of.....*Baptism?First Communion?Confirmation? Add RemoveDate of Baptism Church of Baptism City and State / Country of Baptism Date of First Communion Church of First Communion City and State / Country of First Communion If applicable, please upload child's sacramental certificates.We must have your child's certificates on file. You may also choose to bring the certificates to the religious education office. Drop files here or Select files Accepted file types: pdf, jpg, png, Max. file size: 5 MB, Max. files: 3. Class Options Session 1 Tuesday Afternoon 4:30 PM - 5:45 PM (1,2,3,4,5) Communion I and II Elementary Session 2 Tuesday Evening 6:30 PM - 7:45 PM MS (6,7,8) and HS (9,10,11,12) Confirmation I and II Session 3 Saturday Morning 9:15 AM - 10:30 AM Elementary, Communion I and II (K,1,2,3,4,5) MS (6,7,8) Confirmation I and II MS First Preference*Session 1:Tuesday AfternoonSession 2: Tuesday EveningSession 3: Saturday MorningSecond Preference*Session 1:Tuesday AfternoonSession 2: Tuesday EveningSession 3: Saturday MorningThird Preference*Session 1:Tuesday AfternoonSession 2: Tuesday EveningSession 3: Saturday Morning Student 3Name of Child* First Middle Last Child's Date of Birth* Month Day Year Place of Birth*(City, State, & Country) Age of Child as of September 2024*5 Years6 Years7 Years8 Years9 Years10 Years11 Years12 Years13 Years14 Years15 Years16 Years17 Years18 Years19 YearsGender* Male Female What is the name of the child's school for 2024-2025?* Please select the grade level your child is entering in Fall 2024.*Kindergarten1st2nd3rd4th5th6th7th8th9th10th11th12thDoes the child have any allergies? (Plants, Food, Insects, Medicine)* Yes No List any medical condition or significant medical history, such as allergies or seizures, for which your child requires medication. Please state its type, frequency, and treatment.*If applicable, please explain any physical limitation/disability or learning disability the student has.*Special Needs: Is there anything we need to know to be of better assistance to this child?*Sacrament InformationDid the child receive the Sacraments of.....*Baptism?First Communion?Confirmation? Add RemoveDate of Baptism Church of Baptism City and State / Country of Baptism Date of First Communion Church of First Communion City/State of First Communion If applicable, please upload child's sacramental certificates.We must have your child's certificates on file. You may also choose to bring the certificates to the religious education office. Drop files here or Select files Accepted file types: pdf, jpg, png, Max. file size: 5 MB, Max. files: 3. Class Options Session 1 Tuesday Afternoon 4:30 PM - 5:45 PM (1,2,3,4,5) Communion I and II Elementary Session 2 Tuesday Evening 6:30 PM - 7:45 PM MS (6,7,8) and HS (9,10,11,12) Confirmation I and II Session 3 Saturday Morning 9:15 AM - 10:30 AM Elementary, Communion I and II (K,1,2,3,4,5) MS (6,7,8) Confirmation I and II MS First Preference*Session 1:Tuesday AfternoonSession 2: Tuesday EveningSession 3: Saturday MorningSecond Preference*Session 1:Tuesday AfternoonSession 2: Tuesday EveningSession 3: Saturday MorningThird Preference*Session 1:Tuesday AfternoonSession 2: Tuesday EveningSession 3: Saturday Morning Student 4Name of Child* First Middle Last Child's Date of Birth* Month Day Year Place of Birth*(City, State, & Country) Age of Child as of September 2024*5 Years6 Years7 Years8 Years9 Years10 Years11 Years12 Years13 Years14 Years15 Years16 Years17 Years18 Years19 YearsGender* Male Female What is the name of the child's school for 2024-2025?* Please select the grade level your child is entering in Fall 2024.*Kindergarten1st2nd3rd4th5th6th7th8th9th10th11th12thDoes the child have any allergies? (Plants, Food, Insects, Medicine)* Yes No List any medical condition or significant medical history, such as allergies or seizures, for which your child requires medication. Please state its type, frequency, and treatment.*If applicable, please explain any physical limitation/disability or learning disability the student has.Sacrament InformationDid the child receive the Sacraments of.....*Baptism?First Communion?Confirmation? Add RemoveDate of Baptism Church of Baptism City and State / Country of Baptims Date of First Communion Church of First Communion City and State / Country of First Communion If applicable, please upload child's sacramental certificates.We must have your child's certificates on file. You may also choose to bring the certificates to the religious education office. Drop files here or Select files Accepted file types: pdf, jpg, png, Max. file size: 5 MB, Max. files: 3. Class Sessions Session 1 Tuesday Afternoon 4:30 PM - 5:45 PM (1,2,3,4,5) Communion I and II Elementary Session 2 Tuesday Evening 6:30 PM - 7:45 PM MS (6,7,8) and HS (9,10,11,12) Confirmation I and II Session 3 Saturday Morning 9:15 AM - 10:30 AM Elementary, Communion I and II (K,1,2,3,4,5) MS (6,7,8) Confirmation I and II MS First Preference*Session 1:Tuesday AfternoonSession 2: Tuesday EveningSession 3: Saturday MorningSecond Preference*Session 1:Tuesday AfternoonSession 2: Tuesday EveningSession 3: Saturday MorningThird Preference*Session 1:Tuesday AfternoonSession 2: Tuesday EveningSession 3: Saturday Morning Family and Parent/Guardian InformationFamily Address*Please enter the address where student(s) reside. Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Parent(s) / Legal Guardian(s) that student(s) resides with?*Please inform the religious education office if the parent(s) marital status has changed from previous year. Must provide legal documentation and court orders. Mother & Father Mother Only Father Only Parent (Mother/Father) & Step-Parent Other / Legal Guardian(s) Parent(s) Marital Status* Single Parent(s) - Never Married Common Law (living together - not married) Married Divorced Separated Remarried Widowed (Not Remarried) If the child does not live with both parents, are there any custody issues we must be aware of?* Yes No If parents are separated, divorced, or deceased, or if the child lives with someone other than the natural parents, or if there are other special circumstances, use this space to describe how this situation could affect the religious education classes.Are the parents married civilly or by church?* Married Civilly Married by Catholic Church Not Applicable Parent/Guardian 1: Name* First Middle Last Parent/Guardian 1: Relationship to Child*MotherFatherStep-FatherStep-MotherOther / Legal GuardianParent/Guardian 1: Telephone Number*Parent/Guardian 1: E-mail Address* Enter Email Confirm Email Parent/Guardian 1 is:* Catholic Non-Catholic Christian Other What is the occupation of Parent/Guardian 1?* Parent/Guardian 2: Name* First Middle Last Parent/Guardian 2: Relationship to Child*MotherFatherStep-FatherStep-MotherOther / Legal GuardianParent/Guardian 2: Telephone Number*Parent/Guardian 2: E-mail Address* Enter Email Confirm Email Parent/Guardian 2 is:* Catholic Non-Catholic Christian Other What is the occupation of Parent/Guardian 2?* Parent/Guardian 2: Name First Middle Last Parent/Guardian 2: Relationship to ChildMotherFatherStep-FatherStep-MotherOther / Legal GuardianParent/Guardian 2: Telephone NumberParent/Guardian 2: E-mail Address: Enter Email Confirm Email Parent/Guardian 2 is: Catholic Non-Catholic Christian Other What is the occupation of Parent/Guardian 2? Emergency Contact InformationIn the event of an emergency and we are unable to reach you, please give us the name and contact information of someone to contact that is NOT the child's parent/guardian. This person must have your permission to pick-up your child if necessary.Emergency Contact: Name* First Name Last Name Emergency Contact: Telephone Number*What is his/her relationship to the child(ren)?*(Emergency contact's relationship to child/ren) Permission to Pick-Up ChildPlease list any additional individual(s) other than parent/guardian with permission to pick up child(ren). Additional Contact 1 Name First Last Additional Contact 1: Telephone NumberAdditional Contact 2: Name First Name Last Name Additional Contact 2: Telephone NumberIf applicable, please provide us the name of any individual(s) that is NOT permitted to pick-up child(ren).Must provide legal documentation and court orders to the religious education office.Does your child(ren) have permission to walk home? (Middle & High School Students Only)* Yes No Not Applicable Parent Volunteer OpportunitiesYour contribution of time and talent is crucial to the success of our program. Opportunities for your involvement are listed below. All volunteers make a difference for our kids. Help make a difference in your child's religious education! Please check which options you are interested in! RE Catechist RE Catechist Aide RE Entrance Monitor RE Crossing Guard Office Help Special Event Help Authorization and Medical Insurance InformationPlease read the following information carefully before agreeing and giving permission below. Thank you.Permission and Release of Liability*I / We as the parent(s)/ legal guardian(s) of the child(ren) listed on this registration form give my permission for him/her to attend to Saint Andrew’s Religious Education Program year 2024-2025. In the event of an emergency, I (We), hereby give permission to transport my child to a hospital for emergency medical, dental, anesthetic or surgical treatment. I (We) wish to be advised prior to any non-emergency treatment by the hospital or doctor. I (We) agree to pay for any expenses incurred for such treatment. I (We), individually and in my(our) capacities as parent(s)/legal guardian(s) release, indemnify, and hold harmless the Archbishop of Miami, the Archdiocese of Miami or any parish thereof, its employees, agents, representatives, affiliates, and volunteers from any and all demands, claims, and liability arising out of my child's participation in the program. I (We) hereby waive my claim to a lawsuit against the Archdiocese of Miami or any such persons for any liability arising out of my child's participation in this program. I/ We freely agree and grant permission and release of liability.Medical Insurance Company Medical Insurance ID Number Medical Insurance Group Number Name of Child(ren)'s Physician* Physician's Telephone Number*POLICIES AND GUIDELINESUSE OF PHOTOS: The Parish reserves the right to use student or parent photos in any parish publication and on the parish’s website. Any parent/guardian who does not wish his or her child’s picture or video to be used accordingly must be stated (by not giving permission/consent). Parents/Guardians, by consenting to this acknowledgement of receipt of notice, HEREBY RELEASE St. Andrew Parish, the Archdiocese of Miami, and their corporate members, officers, employees, and agents, from any claims or liabilities that allegedly arise from or are related to the use of student or parent photos.* I/We agree and give permission. I/We DO NOT agree and do not give permission. Safety and Boundaries Lesson: This school year, your child will be presented with a program entitled Empowering God’s Children, in which lesson Leaders present a safety lesson to children that houses a grade-appropriate video component along with a hands-on activity. The material is designed to better equip your child to know their rights, recognize their boundaries, and to empower them to protect themselves when safe adults are not immediately available—and ultimately be safer from people who might want to harm them.* I/We agree and give permission. I/We DO NOT agree and do not give permission. Consent to receive religious education and the sacraments at Saint Andrew Catholic Church*When enrolling a student in the Religious Education Program at Saint Andrew, parents or legal guardians authorize his/her child/youth to receive the Sacrament(s) for which your child/youth is being prepared. I/We affirm that I/we have all rights to give consent for my child to receive religious education and the sacraments at Saint Andrew Catholic Church. Unless the Parish is provided with a court order to the contrary, the person who enrolls the child at the Parish will be deemed to be the primary contact person for all faith formation program-related issues involving the student. I/We agree and give permission.Parent Handbook Acknowledgement* I/ We agree to the privacy policy.Parent or Legal Guardian, I/We acknowledge that I/We have read the entire contents of the Parent-Student Handbook and understand the consequences of any violations of the rules and policies of the Religious Education Program. I/We agree to cooperate with the Religious Education Program to interpret and enforce the policies outlined in the Parent-Student Handbook. I/We also understand that the Pastor has the ultimate authority over the administration of the program and the interpretation of the program’s rules and policies. Moreover, I/We further understand that all of the program policies, whether written or verbal, are only guidelines and are subject to change at the sole discretion of the pastor, with or without notice. I also hereby acknowledge that I/We have read and agree to the terms of the RELEASES outlined in the registration form. Sacramental Certificate(s) for Reception of Sacraments*I/we are aware and accept that in order to receive any of the sacraments of Initiation; I/We need to submit to the Parish of Saint Andrew a copy of the Baptismal Certificate, First Communion, and/or Confirmation Certificate(s) if applicable by the deadline date announced by the Coordinator. I/We understand that the failure to this may result in delaying the reception of the Sacraments. If the child was baptized at St. Andrew Catholic Church, the parent or legal guardian must request a copy to the parish office directly. I/We understand.Commitment*By signing this form, as the parent/legal guardian, I/We acknowledge that I/We accept and agree to follow and abide by all the rules and regulations as stated in the Saint Andrew Parish Religious Education Program handbook. I/We affirm that I have all rights to give consent for my child(ren) to receive religious education and sacraments at Saint Andrew Catholic Church. Also, by signing below, I/We certify that all information provided on the registration and payment form is true and correct. I/We are the parents or authorized guardians of the registered child. I/We fully understand and agree to all the policies, payments, and consent to the enrollment of my child in Saint Andrew Religious Education Program. I/we understand that incomplete registrations will not be processed. I/We agree.Authorization as Parent(s)/Guardian(s)*I/We are the parent(s) or legal guardian(s) of the student(s) named herein and have legal authority to execute the above permissions and to affix my/our signature(s) below. I/We agree.Parent/Guardian 1 Signature*Parent/Guardian 2 Signature*Parent/Guardian 2 Signature Tuition Payment & Billing InformationPlease answer the following questions then enter your payment information then click Submit. Payment must be submitted or your registration will not be received. Thank you and God bless!Are you a registered member of Saint Andrew?*YesNoWhat is your parish envelope number? Tuition*I/We authorize the religious education office to verify our parish affiliation and if applicable adjust tuition accordingly. I/We understand.Email Address (for payment purposes)* Enter Email Confirm Email Tuition*Tuition for 2024-2025 is $150 for registered parishioners and $250 for non-registered parishioners. Note: Parish affiliation will be verified and tuition will be adjusted accordingly. Current Students/Family Full Tuition (Registered Parishioners) - $150 Current Students/Family Full Tuition (Non-Registered Parishioners) - $250 Processing Fees*A 2.5% processing fee will be added to your amount due. Price: $0.00 Total Amount Due: Credit Card* American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20242025202620272028202920302031203220332034203520362037203820392040204120422043 Security Code Cardholder Name PhoneThis field is for validation purposes and should be left unchanged.
