Kindergarten: 11:00-12:00 In School Building 2018-2019 Holy Name of Jesus Religious Education Registration hnsred@gmail.com hnjparish.com 914-563-1017 Tuition Fees: 1 Child $300 2 Children $350 3 Children $400 **If you have only 1 child in K tuition is 125.00 other wise multi discount price above. Class Times: Kindergarten: 11:00-12:00 In School Building Grades 1-6 Sunday 10am Mass followed by class in School 11:00am-12:15pm Grades 7-8 Tuesday Night 6:30-7:45 (Still must attend weekly Sunday Mass) Grade 6th 6:30-7:45 You must choose 6th Tuesday or 6th Sunday (circle your choice) Family Name _________________________________________________________________________ Mother’s Maiden Name __________________________Father’s Name___________________________ Street Address_______________________________ City_________________ Zip_________________ Home Phone_____________________ Mother’s Cell _______________Father’s Cell _______________ Email Address #1 ______________________________ Email Address #2 _________________________ Name of Child: ___________________________________________________________________ Gender: M/F___ Grade in Sept: ________ Birth Date:_____ School Child Attends:____________ Date of Baptism:_________________ Church of Baptism: _________ Allergies__________________ Name of Child: ___________________________________________________________________ Gender: M/F___ Grade in Sept: ________ Birth Date:_____ School Child Attends:____________ Date of Baptism:_________________ Church of Baptism: ______ Allergies __________ Name of Child: ___________________________________________________________________ Gender: M/F___ Grade in Sept: ________ Birth Date:_____ School Child Attends:____________ Date of Baptism:_________________ Church of Baptism:_______________ Allergies ___________ Name of Child: ___________________________________________________________________ Gender: M/F___ Grade in Sept: ________ Birth Date:_____ School Child Attends:____________ Date of Baptism:_________________ Church of Baptism: __________ Allergies______________ Baptismal Certificates must be presented if baptized in a church other than Holy Name Candidate for Reconciliation & Eucharist (Other than Grade2) _______________________________ __________________________________________________________________________________

Permission to use Photographs Talk to us! The more we know about your child the better we can help them in their faith journey! If Your child has a learning disability, food allergies, medical conditions, or if he/she requires accommodations, please indicate bellow: ___________________________________________________ ____________________________________________________________________________________ Volunteers Needed! ________ Catechist for Grade______________ ________ Substitute Teacher Sunday Tuesday Night ________ Hall Aide/ Security Sunday Tuesday Night ________ Office Assistant (Sunday Only) ________ Catechist Assistant (Sunday Only) ________ Christmas Pageant Help _________Family Community Service Projects ________ Special Talents Share Below _________________________________________________ Permission to use Photographs Check mark for yes ____ I __________________________ (Parent or Guardian) allow photos of my child(ren) taken during religious education activities and sponsored events to be published on the Holy Name website, Facebook page or in local print publications for any lawful purpose, including publicity, illustration, advertising, and web Content. Religious Education Classes are for members of the Holy Name of Jesus Parish. If you have not registered Please print the parishioner registration form (different than Religious Education Registration) from our website www.hnjparish.com. This will allow us to send you all of our church mailings, calendars as well as invitations to special events throughout the year. We also ask for your family to attend Sunday Mass each week and support the church. In case of accident or illness, I request that the representative of the parish catechetical program contact me. If I am unable to be reached, I hereby authorize this representative to make whatever arrangements seem necessary. I agree to assume the financial responsibility for any diagnosis, treatment and/or medication deemed necessary. To the best of my knowledge all information given is accurate and complete. I hereby consent to , and authorize the necessary procedures that have been stated above. Parent/Guardian Signature: ________________________________________ Date:___________