PSR Registration FormSacred Heart Catholic ChurchParish School of Religion (PSR) Registration FormGrades K thru 8 Student's First Name * Middle Name * Last Name * Birth Date MM DD YYYY Grade * K 1 2 3 4 5 6 7 8 Baptized * Yes No Church of Baptism * First Communion * Yes No Email * Phone * (###) ### #### Parent #1/Guardian Name * First Name Last Name Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Parent #1/Guardian Phone * (###) ### #### Parent #1/ Guardian Email * Parent #2/Guardian Name First Name Last Name Address Parent #2/Guardian Address 1 Address 2 City State/Province Zip/Postal Code Country Parent #2/Guardian Phone (###) ### #### Parent #2/Guardian Email Family is Registered With (Name of Parish) * Allergies Or Medical Conditions * None Yes If Yes, please explain: Authorized Person(s) to Pick Up Child(ren): * Please list the name(s) of those authorized to pick up child(ren) Thank you!
