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  • Family Name REQUIRED Please fill out this field. Please enter valid data.
  • Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  • Mother's Cell Phone Number Please enter a phone number.
  • Father's Cell Phone Number Please enter a phone number.
  • Email REQUIRED Please fill out this field. Please enter an email address.
  • Street Address REQUIRED Please fill out this field. Please enter valid data.
  • City REQUIRED Please fill out this field. Please enter valid data.

    State REQUIRED AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MH MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR PW RI SC SD TN TX UT VA VI VT WA WI WV WY Please fill out this field.

    Zip REQUIRED Please fill out this field. Please enter a zip code.
  • Session selection will be honored based on availability and all unpaid balances must be paid in full. Registrations received after June 30th will be at the higher rate. If there is a financial concern, please contact our business manager, Mr. Lou Tonelli in the Parish Office at 215-362-7400.
  • Session Selection Tuesday, 4:40-6:00 Wednesday, 4:40-6:00 Wednesday eve. 6:30-7:50
  • Tuition:
    1 child $
    2 children $
    3 children $
    (each additional child $100)
    
    Materials fee:
    First Penance/First Holy Communion $
    Confirmation $
  • Number of Students Returning REQUIRED Please fill out this field. Please enter an integer (number).
  • Returning Student 1 REQUIRED Please fill out this field. Please enter valid data.
  • Grade Next Year REQUIRED Please fill out this field. Please enter an integer (number).
  • School REQUIRED Please fill out this field. Please enter valid data.
  • Returning Student 2 Please enter valid data.
  • Grade Next Year Please enter an integer (number).
  • School Please enter valid data.
  • Returning Student 3 Please enter valid data.
  • Grade Next Year Please enter an integer (number).
  • School Please enter valid data.
  • Returning Student 4 Please enter valid data.
  • Grade Next Year Please enter an integer (number).
  • School Please enter valid data.
  • Number of New Siblings Please enter an integer (number).
  • New Student 1 Please enter valid data.
  • Grade Next Year Please enter an integer (number).
  • School Please enter valid data.
  • New Student 2 Please enter valid data.
  • Grade Next Year Please enter an integer (number).
  • School Please enter valid data.
  • Is there a custody agreement concerning your child(ren)? If yes, please provide a complete copy of the latest court order. Yes No
  • Emergency Contact Information: If we are unable to reach you, whom should we contact?
  • Name: REQUIRED Please fill out this field. Please enter valid data.
  • Relationship REQUIRED Please fill out this field. Please enter valid data.
  • Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  • Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  • Consent for Medical Care: I give permission that, in my absence, my children whose name appear on this registration form may receive emergency medical care for injuries and all situations that should occur while participating in the Religious Education Program and activities at Mary, Mother of the Redeemer Parish.
    
    Medical/Learning Data: If any of the following apply to your child, please list his/her name and give details.
  • Child's Name Please enter valid data.
  • Medical Conditions/Allergies Please enter valid data.
  • Prescribed Medications Please enter valid data.
  • Disability/Learning Support Services Please enter valid data.
  • IEP Yes No
  • By re-registering my chid(ren) I agree to abide by the policies listed in the PREP Handbook. I am aware it is my responsibility to review the handbook online prior to the start of PREP in September.

    I Agree Please select this field.
  • I give permission for my child's picture to appear on the parish name website, bulletin boards, newspaper articles in relation to events that happen in the parish. I give permission for my child to be photographed during sacrament celebrations.

    I Agree Please select this field.
  • I Disagree Please select this field.
  • Parent/Legal Guardian: REQUIRED Please fill out this field. Please enter valid data.
  • Date REQUIRED Please fill out this field. Please enter a date.

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