Our Lady of Perpetual Help Parish Religious Education Program
Morton, PA

Registration 2008 - 2009



Parent Information:				Account No.

Name of Father:  				Father’s Religion:		Living/Dec.

Last__________________	First__________________

Name of Mother:				Mother’s Religion:		Living/Dec.

Last__________________	First__________________	Maiden_______________

Address:

	
Home Phone:

Work Phone:

Emergency Contact (Name & Phone):

Do you live in OLPH Parish?		Are you registered in OLPH Parish?

Other Family Background:  (Check if applicable)

Parents Separated_____     Divorced_____     Remarried_____     Single Parent_____

Name/Address/Phone of Step-Parent or Guardian (if applicable):


Who is responsible for child’s religious education?

Parents_____     Mother_____     Father_____     Grandparents_____     Other_____

If “Grandparents” or “Other”, list name, address and phone number:






Student Information:

Child #1

Last Name:				First Name:				M / F

Date of Birth:				City of Birth:

Date of Baptism:			Church of Baptism:

Date of Communion:			Church of Communion:

Date of Confirmation:		Church of Confirmation:

School Child Attends:

Child #2

Last Name:				First Name:				M / F

Date of Birth:				City of Birth:

Date of Baptism:			Church of Baptism:

Date of Communion:			Church of Communion:

Date of Confirmation:		Church of Confirmation:

School Child Attends:

Child #3

Last Name:				First Name:				M / F

Date of Birth:				City of Birth:

Date of Baptism:			Church of Baptism:

Date of Communion:			Church of Communion:

Date of Confirmation:		Church of Confirmation:

School Child Attends:
Any pertinent health information about your child/ren that we should know about?
(e.g. asthma, allergies, seizures, ADD, special education)
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