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Confirmation Registration

- Religious Ed
Contact Us
- John LaDuca
  
  Deacon - Religious Education Grades 7 & 8 - Confirmation
  
  201-891-1122
  JLaducasaintelizabeths.org
- Donna Jackson
  
  Religious Education
  
  201-891-3262 ext. 228
  DonnaJsaintelizabeths.org

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- Family Name REQUIRED Please fill out this field.
- Family E-Mail REQUIRED Please fill out this field. Please enter an email address.
- Home Phone REQUIRED Please fill out this field. Please enter valid data.
- Home Address 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.
- Emergency Contact & Phone REQUIRED Please fill out this field. Please enter valid data.
- Name of Father REQUIRED Please fill out this field. Please enter valid data.
- Father Cell Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Religion REQUIRED Please fill out this field. Please enter valid data.
- Name of Mother REQUIRED Please fill out this field. Please enter valid data.
- Mother Cell Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Religion REQUIRED Please fill out this field. Please enter valid data.
- For Parents: If you are not Catholic or have not completed all the Sacraments, would you be interested in learning more about the Rite of Christian Initiation of Adults (RCIA)? REQUIRED Please fill out this field.
- Child Lives With REQUIRED Please fill out this field.
- If divorced, is there joint custody? Yes No
- Is an email to another parent required? REQUIRED Please fill out this field.
- If yes, Other Parent Name & Cell Number Please enter valid data.
- Other Parent Email (if required) Please enter an email address.
- How many teens are you registering? REQUIRED Please fill out this field.
  
  Teen 1
  
  Teen Candidate Name Please enter valid data.
  
  Grade (as of September 2021) REQUIRED Please fill out this field.
  
  Gender REQUIRED Please fill out this field.
  
  High School REQUIRED Please fill out this field. Please enter valid data.
  
  Teen Candidate Cell REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Teen Candidate Email REQUIRED Please fill out this field. Please enter an email address.
  
  Does your child have allergies? REQUIRED Please fill out this field.
  
  If yes, please describe
  
  Please help us to meet your childs needs by indicating any special assistance or modifications received in school. REQUIRED Please fill out this field.
  
  If yes, please describe
  
  Teen 2
  
  Teen Candidate Name Please enter valid data.
  
  Grade (as of September 2021) REQUIRED Please fill out this field.
  
  Gender REQUIRED Please fill out this field.
  
  High School REQUIRED Please fill out this field. Please enter valid data.
  
  Teen Candidate Cell REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Teen Candidate Email REQUIRED Please fill out this field. Please enter an email address.
  
  Does your child have allergies? REQUIRED Please fill out this field.
  
  If yes, please describe
  
  Please help us to meet your childs needs by indicating any special assistance or modifications received in school. REQUIRED Please fill out this field.
  
  If yes, please describe
  
  Teen 3
  
  Teen Candidate Name Please enter valid data.
  
  Grade (as of September 2021) REQUIRED Please fill out this field.
  
  Gender REQUIRED Please fill out this field.
  
  High School REQUIRED Please fill out this field. Please enter valid data.
  
  Teen Candidate Cell REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Teen Candidate Email REQUIRED Please fill out this field. Please enter an email address.
  
  Does your child have allergies? REQUIRED Please fill out this field.
  
  If yes, please describe
  
  Please help us to meet your childs needs by indicating any special assistance or modifications received in school. REQUIRED Please fill out this field.
  
  If yes, please describe
- Payment REQUIRED Please fill out this field.
- Parent Volunteer Options REQUIRED Please fill out this field.
- Parent Volunteer Name Please enter valid data.
- I authorize my child/children to participate in Religious Education at St. Elizabeth's. I understand that images or photos of my child (without names) taken during programs can be used for parish materials (ie Bulletin, Website and Parish Mini Magazine).
  I Agree Please select this field.
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