Registration – St. Catherine of Siena Parish

St. Catherine of Siena Parish
Religious Education Registration Form 2025-2026

Please plan to take enough time to fill out EVERY INFORMATION BLOCK (Child’s Name/Parent Name/Pick up Person/Emergency contact/etc.) for EACH CHILD completely and clearly. This VITAL INFORMATION will be generated onto your CHILD’S NAMETAG not only for their IDENTIFICATION but SAFETY purposes as well!

PAYMENT(S) should accompany the completed registration(s) forms. Payments maybe combined and can be submitted ONLINE under the “ONLINE GIVING” tab on our website, or by visiting the following link :

https://northpoconocatholic.weshareonline.org/ws/opportunities

or by placing the payment in the collection basket at weekend Mass or giving it to your child’s teacher. Please make checks payable to “St. Catherine of Siena” and clearly label envelopes with your child’s name and grade.

FEES:

$10 for Kindergarten

$35 for Grades 1-6

$45 for Confirmation I & II
(Inability to pay need not deter children from the program)

Fields marked with * are required.

Primary Email *

PARENT INFOPlease enter only the PARENT’S INFO here, not the student info!

Mother's Maiden Name

Mother's First Name

Mother's Last Name

Mother's Cell PhoneEnter digits only.

Father's First Name

Father's Last Name

Father's Cell PhoneEnter digits only.

Home PhoneEnter digits only.

Email Address(If different than the primary email.)

Student Pickup Person #1 *You must have at least 1 pickup person identified. You can have up to 4, but it’s not necessary to identify 4 people.

Pickup Person #1 Phone Number *Enter digits only.

Pickup Person #2

Pickup Person #2 Phone NumberEnter digits only.

Pickup Person #3

Pickup Person #3 Phone NumberEnter digits only.

Pickup Person #4

Pickup Person #4 Phone NumberEnter digits only.

Emergency Contact

Emergency Contact First Name *

Emergency Contact Last Name *

Emergency Contact Cell PhoneEnter digits only.

Emergency Contact Home PhoneEnter digits only.

Health & Safety

Student's Medical Information

Custody Information

Parent Responsibilities

Will you read the contents of the Religious Education Program Handbook? *NoYes

Do you agree that weekly Mass attendance is an integral part of religious education? *NoYes

Do you understand that child absences are reported using Remind or by calling (570) 848-1258? *NoYes

Do you understand that when classes are canceled due to weather conditions, it will be found on our website (scscmoscow.com), by calling (570) 848-1258, or by following Remind? *NoYes

Media Release

Do you give permission to have your child's picture/video on parish website, social media, or bulletin? *NoYes