Re-Registration 2021-2022

Please complete ONE below form per family!

Welcome back to PSR!

 

PSR will be held for Grades K-4 on Sundays starting September 12, 2021 from 8:30am to 9:45am in the Parish Center. 

 

Grades 5-8 will be on Wednesdays starting September 8, 2021 from 6:30pm to 7:45pm in the Parish Center.

 

Confirmation will be on scheduled Sundays 8:30am to 9:45am in the Parish Center. See "Confirmation" page for schedule.

 

PLEASE NOTE: No Preschool class this year.

Information
Family Name
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Phone --
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Address
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Child Resides With
  •  
Additional Information
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Please list other information: (new baby, adoption, separation, divorce, new marriage, serious illness, etc.)
Emergency Contact
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Emergency Contact Phone -- ext
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Please select one
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Additional Information
Phone --
  •  
E-mail
  •  
To be used for emailing PSR schedule changes and updates.
Choose one or more
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1. Child's Name
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Please complete an entry per child returning for their 2021-2022 PSR school year.
Date of Birth //
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School & Grade 2021-22
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PSR Grade 2021-22
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Please call the Parish Office (440-428-5164) to register any *NEW* child to PSR.
2. Child's Name
  •  
Date of Birth //
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School & Grade 2021-22
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PSR Grade 2021-22
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3. Child's Name
  •  
Date of Birth //
  •  
School & Grade 2021-22
  •  
PSR Grade 2021-22
  •  
4. Child's Name
  •  
Date of Birth //
  •  
School & Grade 2021-22
  •  
PSR Grade 2021-22
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Special Instructions/Medical
Allergies
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If yes, please list what they are
Medications
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Learning Disabilities
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Fears
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Rates
The rates for 2021-2022 PSR school year; $50 first child, $75 two children, $100 for three or more children. Please call the Parish Office (440-428-5164) if financial assistance is needed.
Photo Release
We understand that permission is required for our child's photograph to be published in Immaculate Conception newsletter, local newspapers, publicity brochures, our website, or TV if the occasion should arise. This permission is given for the duration of our child's education at Immaculate Conception Church.
Permission Options
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Parent's Signature
Parent or Guardian Signature
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Please enter your first and last name as your electronic signature.
Spam Capture
  •  
 
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