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Elementary Religious Education

- Religious Education

The Jay and Randolph County Catholic Pastorate invites you to register your student(s) for our religious education programs.

You may register your children online using the form below and indicating your home parish.

Please visit the home page for your parish below.

RANDOLPH COUNTY
- St. Mary - Union City
- St. Joseph - Winchester
JAY COUNTY
- Immaculate Conception - Portland
- Holy Trinity - Bryant
REGISTRATION
The maximum number of form submissions has been reached. This form is currently not available.
- Family information
  
  Father's Name REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Home Parish REQUIRED Please fill out this field.
  
  Preferred language REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Name REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Preferred language REQUIRED Please fill out this field. Please enter valid data.
- STUDENT INFORMATION
- How many students will you register? REQUIRED Please fill out this field.
  
  Children 1
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of birth REQUIRED Please fill out this field. Please enter valid data.
  
  Gender
  
  Grade
  
  Sacraments received Baptism First Communion Confirmation
  
  What parish was your child baptized in? REQUIRED Please fill out this field. Please enter valid data.
  
  Children 2
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of birth REQUIRED Please fill out this field. Please enter valid data.
  
  Gender
  
  Grade
  
  Sacraments received Baptism First Communion Confirmation
  
  What parish was your child baptized in? REQUIRED Please fill out this field. Please enter valid data.
  
  Children 3
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of birth REQUIRED Please fill out this field. Please enter valid data.
  
  Gender
  
  Grade
  
  Sacraments received Baptism First Communion Confirmation
  
  What parish was your child baptized in? REQUIRED Please fill out this field. Please enter valid data.
  
  Children 4
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of birth REQUIRED Please fill out this field. Please enter valid data.
  
  Gender
  
  Grade
  
  Sacraments received Baptism First Communion Confirmation
  
  What parish was your child baptized in? REQUIRED Please fill out this field. Please enter valid data.
  
  Children 5
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of birth REQUIRED Please fill out this field. Please enter valid data.
  
  Gender
  
  Grade
  
  Sacraments received Baptism First Communion Confirmation
  
  What parish was your child baptized in? REQUIRED Please fill out this field. Please enter valid data.
  
  Children 6
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of birth REQUIRED Please fill out this field. Please enter valid data.
  
  Gender
  
  Grade
  
  Sacraments received Baptism First Communion Confirmation
  
  What parish was your child baptized in? REQUIRED Please fill out this field. Please enter valid data.
  
  Children 7
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of birth REQUIRED Please fill out this field. Please enter valid data.
  
  Gender
  
  Grade
  
  Sacraments received Baptism First Communion Confirmation
  
  What parish was your child baptized in? REQUIRED Please fill out this field. Please enter valid data.
  
  Children 8
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of birth REQUIRED Please fill out this field. Please enter valid data.
  
  Gender
  
  Grade
  
  Sacraments received Baptism First Communion Confirmation
  
  What parish was your child baptized in? REQUIRED Please fill out this field. Please enter valid data.
- I hereby warrant that to the best of my knowledge, my child is in good health and I assume all responsibilities for the health of my child.
  I Agree Please select this field.
- Emergency Medical Treatment: In the event of an emergency, I hereby give permission to Holy Family Parishes to transport my child to a hospital for emergency medical or surgical treatment. I wish to be advised prior to any further treatment by the hospital or doctor.
  I Agree Please select this field.
- Please list conditions/needs/allergies for your child(ren) that are important to know:
- EMERGENCY CONTACT
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Volunteers are welcome, needed and appreciated! Please indicate below if you are interested in helping with any of these positions:
Submit

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