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Holy Family Religious Education Center - Registration

The Holy Family Center for Religious Education

303 Paris Street, East Boston, MA 02128

Phone:  617.567.6509  Fax:  617.567.2561

Registration Application

School Year 2011 - 2012

Office use only

                                                                                                                                                                                                         
                                    Application  Date:  ____________________________                         Entered in Computer:   ___________________________
                                    Received Payment: ___________________________                         Teacher: _______________________________________
                                    Rec #______________                                                                           Check#_____________

__________________________________________________________________________________________________________________________

 

 

Name:_______________________________________________________________________________________________

                               FIRST                           FULL MIDDLE                                       LAST

Home Address:_______________________________________________________________________________________

City:__________________________________ Zip:______________ Home Phone:  ______________________________

                                                                                                                                   (Area Code & Phone No.)

Date of Birth: _________/_________/_____________(Month/Day/Year)                                                      

FEMALE:______________________   MALE__________________

New to Holy Family Center:       Yes    No    (Circle One)*

If yes, prior religious education: _________________________________________________

Date of Baptism: _____________/____________/____________(Month/Day/Year)*                               

Church of Baptism:________________________________________ City & State: __________________

Date of First Holy Communion____________/______________/________________(Month/Day/Year)*

Church of Holy Communion:_______________________ City & State: ___________________

School Student Attends:_________________________________ Grade in Sept 2008:______ 

Special Needs:_____________________________ Learning Disabilities:_________________

 

Health Information/Allergies:___________________________________________________

Language spoken at home:_____________________________________________________

Mother's Name___________________________________________________________________________

                             FIRST                                FULL MIDDLE                             LAST

Father's Name____________________________________________________________________________

                             FIRST                                FULL MIDDLE                             LAST

Name of Parent/guardian responsible for receiving mail:________________________________________________

Parent/guardian's email address: ____________________________________________________________________

 

In case of emergency and if we can't contact the parent/guardian first, please list two other responsible adults we should contact.

Name:________________________________________________ Relationship:__________________________________

Area Code and Phone Number:__________________________________________________

 

Name:________________________________________________ Relationship:__________________________________

Area Code and Phone Number:__________________________________________________

  

*Please note*:  If it is your first year with the Holy Family Center, and your child received Baptism or First Holy Communion somewhere other than Sacred Heart Parish, you must present your child's Baptismal Record and/or First Communion Record.  We will be happy to make a copy and return the original to you.

 

2011 Pricing: 

Please see Mrs. Cheryl DeModena in the office or call her at 617.567.6509 to make payments or payment plans.

$70.00 for the 1st  child in a family

  50.00 for the 2nd child

  30.00 for the 3rd child

__________________

$150.00 total for 3 or more students in a family.

 

Please Note:  Those children attending Catholic Schools in grades 2, 9 and 10 must also register as part of our

Sacramental Program at a cost of $25.00.