&lt;span&gt;Registration Form&lt;/span&gt;

Family Last Name REQUIRED Please fill out this field. Please enter valid data.

Address (Street, Apt#, City & Zip) REQUIRED Please fill out this field. Please enter valid data.

Best Phone Number for Communication REQUIRED Please fill out this field. Please enter valid data.

Best Email for Communication REQUIRED Please fill out this field. Please enter valid data.

Was your family enrolled in St. Mark RE in 2020-2021? REQUIRED Yes No Please fill out this field.

Father's First and Last Name REQUIRED Please fill out this field. Please enter valid data.

Is the Father a Roman Catholic? REQUIRED Yes No Please fill out this field.

Mother's First and Last Name REQUIRED Please fill out this field. Please enter valid data.

Is the Mother Roman Catholic? REQUIRED Yes No Please fill out this field.

Full Name (Student 1) REQUIRED Please fill out this field. Please enter valid data.

Date of Birth (Student 1) REQUIRED Please fill out this field. Please enter valid data.

Gender (Student 1) REQUIRED Please fill out this field. Please enter valid data.

Previous Year RE History (Student 1) REQUIRED Enrolled in Religious Education at St. Mark last year Enrolled in Religious Education at a different parish last year (documentation verifying involvement will be requested) Not enrolled in Religious Education last year Please fill out this field.

For Student 1: I am requesting registration for the following program(s): REQUIRED K-5 Program First Reconciliation/First Communion Preparation Edge Middle School Youth Ministry Teen Confirmation (must also be enrolled in Life Teen) Life Teen High School Youth Ministry K-5 Family Faith Formation Please fill out this field.

Sacraments Received prior to this school year (Student 1) REQUIRED Baptism First Reconciliation First Eucharist Confirmation Please fill out this field.

Allergies, Dietary Restrictions, and/or Chronic Medical Problems (Student 1) REQUIRED Please fill out this field. Please enter valid data.

Full Name (Student 2) Please enter valid data.

Date of Birth (Student 2) Please enter valid data.

Gender (Student 2) Please enter valid data.

Previous Year RE History (Student 2) Enrolled in Religious Education at St. Mark last year Enrolled in Religious Education at a different parish last year (documentation verifying involvement will be requested) Not enrolled in Religious Education last year

For Student 2: I am requesting registration for the following program(s): K-5 Program First Reconciliation/First Communion Preparation Edge Middle School Youth Ministry Teen Confirmation (must also be enrolled in Life Teen) Life Teen High School Youth Ministry K-5 Family Faith Formation

Sacraments Received prior to this school year (Student 2) Baptism First Reconciliation First Eucharist Confirmation

Allergies, Dietary Restrictions, and/or Chronic Medical Problems (Student 2) Please enter valid data.

Full Name (Student 3) Please enter valid data.

Date of Birth (Student 3) Please enter valid data.

Gender (Student 3) Please enter valid data.

Previous Year RE History (Student 3) Enrolled in Religious Education at St. Mark last year Enrolled in Religious Ed. at a different parish last year (documentation verifying involvement will be requested) Not enrolled in Religious Education last year

For Student 3: I am requesting registration for the following program(s): K-5 Program First Reconciliation/First Communion Preparation Edge Middle School Youth Ministry Teen Confirmation (must also be enrolled in Life Teen) Life Teen High School Youth Ministry K-5 Family Faith Formation

Sacraments Received prior to this school year (Student 3) Baptism First Reconciliation First Eucharist Confirmation

Allergies, Dietary Restrictions, and/or Chronic Medical Problems (Student 3) Please enter valid data.

Full Name (Student 4) Please enter valid data.

Date of Birth (Student 4) Please enter valid data.

Gender (Student 4) Please enter valid data.

Previous Year RE History (Student 4) Enrolled in Religious Education at St. Mark last year Enrolled in Religious Education at a different parish last year (documentation verifying involvement will be requested) Not enrolled in Religious Education last year

For Student 4: I am requesting registration for the following program(s): K-5 Program First Reconciliation/First Communion Preparation Edge Middle School Youth Ministry Teen Confirmation (must also be enrolled in Life Teen) Life Teen High School Youth Ministry K-5 Family Faith Formation

Sacraments Received prior to this school year (Student 4) Baptism First Reconciliation First Eucharist Confirmation

Allergies, Dietary Restrictions, and/or Chronic Medical Problems (Student 4) Please enter valid data.

PRICING

One Child	Two Children
$80	$130
Three Children or More
$200

Family Faith Formation

$100

$20 sacramental preparation fee (only for those enrolled this year in First Communion and/or Confirmation)

Please total your registration fee in the box below. REQUIRED

Pricing for Religious Education Fees: $50 for one child $90 for two children $125 for three or more $10 sacramental preparation fee (only for those enrolled this year in First Communion and/or Confirmation)

Please fill out this field. Please enter valid data.

I will pay by: REQUIRED Online Giving (Credit Card or e-Check) Credit Card (In Person) Check (In Person) Cash (in-Person) Please fill out this field.

I certify that when my child(ren) attend RE that they have none of the COVID 19 symptoms. I hereby agree to waive any claims against St. Mark as a result of the Covid-19 pandemic. REQUIRED Yes Please fill out this field.

I grant St. Mark permission to publish photographs and videos taken of my child on the St. Mark website, bulletin and social media. REQUIRED Yes Please fill out this field.

Online registration will be processed by a RE staff member as quickly as possible. You will receive a confirmation email from a RE staff member within 1-2 business days.

I would like to receive a confirmation phone call when my registration is processed. No Yes

Would you like information for St. Mark the Evangelist Youth Choir? No Yes

Are you interested in being a Facilitator for Mom's Group? Meets during Tuesday K-5 RE! REQUIRED Yes No Please fill out this field.

If you would like religious education for your child that has learning disabilities, please contact Camryn Breese, redirector@stmarkov.com.