Blessed Trinity Catholic Church

Email *

Student's Name: *

Please attach a current photograph of your child

Gender: *

Place of birth *

Date of birth *

Race/Ethnicity *

Street Address: *

City and Zip Code: *

Home Telephone Number *

Father's Full Name: *

Father's Mobile Phone Number *

Father's Email Address *

Father's Religion: *

Mother's Full Name: *

Mother's Mobile Phone Number *

Mother's Mail Address *

Mother's Religion: *

Emergency Contact Phone Number (other than parent's): *

Does child live with both parent's? *

Person's authorized to pick up *

Person's NOT AUTHORIZED to pick up *

Student's grade in September 2023 *

School attending *

Parish where family is registered & parishioner # *

Has the student attended Religious Education or Catholic School this past school year?

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If yes, where? Years attended:

Has student been Baptized? *

If yes please list Month, day, year:

If yes, please list church city, state:

Has student received First Holy Communion?

If yes please list Month, day, year:

If yes, please list church city, state:

If your child is NOT BAPTIZED BOTH parents and/or legal guardians must provide written consent on additional form which we will provide.

List any medical conditions including allergies or learning challenges: *

Safe Environment Program: Teaching children to protect themselves is part of the mandate of the Charter for the Protection of Children and Young People adopted by the United Stated conference of Catholic Bishops in June, 2002. During the school year we will teach two lessons for all grades. These sessions are merely to reinforce what you teach at home. Materials for parents are available in the Religious Education Office and at http://www.virtusonline.org/mypage/exploringvirtus.cfm

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I hereby authorize my child whose name is listed above and for whom I am filling out this form to use the digital platforms, tools, and applications selected by Blessed Trinity religious Education, including but not limited to Zoom.

I understand that these third-party platforms may maintain their own privacy policies, terms, and conditions for which Blessed Trinity Religious Education cannot control or assume responsibility.

I further understand that to facilitate program activities, these online platforms often include video and audio conferencing, recording, and other electronic communication forms

Additionally, I understand that this online plan, as well as those directives and requirements related to this plan of learning, may be amended at any time at the sole discretion of the Blessed Trinity Religious Education Office with or without notice.

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Please attach student's Birth Certificate

Please attach student's Baptism Certificate if applicable

Please attach First Holy Communion Certificate if applicable

Tuition is $170.00 per year, per child in PK - Pre-Confirmation. Tuition for Confirmation students is $190.00 per year.

You may use the accompanying QR Code to submit payment with your cell phone or you may pay in cash or by check at the Parish Office.

Payments must be received before the 1st day of class. Monthly payment arrangements may also be made by credit card.

Please note that there will be a 3% surcharge when paying by credit card.

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Tuition is $170.00 per year, per child in PK - Pre-Confirmation. Tuition for Confirmation students is $190.00 per year.

You may use the accompanying QR Code to submit payment with your cell phone or you may pay in cash or by check at the Parish Office.

Payments must be received before the 1st day of class. Monthly payment arrangements may also be made by credit card.

Please note that there will be a 3% surcharge when paying by credit card.

Credit Card (using code above)

Cash (Parish Office)

Check (Parish Office)

Father's Electronic Signature Below

By providing my signature, I agree that it will be the electronic representation of my signature for all purposes when I use it on documents, including legally binding contracts - just the same as pen-and-paper signature.

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Mother's Electronic Signature Below

By providing my signature, I agree that it will be the electronic representation of my signature for all purposes when I use it on documents, including legally binding contracts - just the same as pen-and-paper signature.

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Father E-Signature *

Mother E-Signature *