Immaculate Conception Parish
Religious Education Registration

• All 2012-2013 Religious Education Program Forms
• Annual Consent and Release Form - this form needs to be filled out and sent to the Parish Center for each child in our program.
• Online Volunteer Registration Form - Thank you!

Welcome to the Immaculate Conception Parish Religious Education Program! You will find detailed information about our available programs in the Program Information document above, along with cost information . Please consider volunteering as a catechist or assistant. If you are able to answer this call, fill out our online volunteer registration form .

You may register your child for our program in one of two ways:

1. Fill out the online form below. Your registration will be complete after you print out the Payment Form above and bring it to the Parish Office along with payment, or pay online with PayPal . You may also mail your payment to us at 455 Bow St. Extended, Elkton, MD 21921 . *PayPal payment is only available for re-registrations. New families must pay by printing the payment form and bringing it to the parish center.
2. Print out All Religious Education Program Forms , fill them out, and bring them into the Parish Office along with payment, or mail them to us at 455 Bow St. Extended, Elkton, MD 21921 .

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Online Religious Education Registration Form

Please check the following box before continuing to fill out the form:

I understand that to complete my registration, I must bring the payment form and deposit to the Parish Center, mail it to 455 Bow St. Extended, Elkton, MD 21921 , or complete payment using the PayPal button at the end of the online registration process. *PayPal payment is only available for re-registrations. New families must pay by printing the payment form and bringing it to the parish center after completing this form.

Family Information
Family Name:
Father's Full Name:
Mother's Full Name: (including maiden)
Child's Primary Residence:	Address:
	City:
	State:	Zip:
Child's Alternate Residence:	Address:
	City:
	State:	Zip:
Father's Phone Numbers:	Home:
	Cell:
	Work:
Mother's Phone Numbers:	Home:
	Cell:
	Work:
Father's Email Address: (you will receive an email confirmation at this address if filled in)
Mother's Email Address: (you will receive an email confirmation at this address if filled in)
Father's Preferred Contact Method for reminders, updates, weather cancellations, etc.:	Email Text Phone (cell number) Phone (home number)
Mother's Preferred Contact Method for reminders, updates, weather cancellations, etc.:	Email Text Phone (cell number) Phone (home number)
Our family is currently registered at:	Parish
NOTE: If your family is not registered at ICC Parish, you must submit a letter from your parish for your child(ren) to attend religious education classes here. NOTE: All NEW families must submit a copy of Baptismal, Reconciliation, and Communion Certificates for each child.

Student Information (First Student)
Full Name:
Date of Birth:
Grade in School in Fall:
School Attending in Fall:
Baptism:	At ICC/St. Jude Other Parish If child was baptized at another parish and we do not have your records already, you must submit a copy of his/her Baptismal Certificate with your registration.
Sacraments already received:	Reconciliation First Eucharist Confirmation
Sacraments to be received this year:	First Reconciliation (Grade 2 and above) First Eucharist (Grade 2 and above) Confirmation (Grade 9 - 12)
Previous Religious Education:	At ICC/St. Jude Other Parish None If child attended a religious education program at another parish last year, you must submit a letter from the parish or Catholic School indicating the grades and years attended and sacraments received with your registration.
Preschool (age 3-4-5) Session Choice:	3-Year-Old Program: Sunday mornings from 10:15 - 11:30AM Sept. - May 4-Year-Old Program: Sunday mornings from 10:15 - 11:30AM Sept. - May Kindergarten Program: Sunday mornings from 10:15 - 11:30AM Sept. - May
Grade 1 - 8 Session Choice:	Sunday mornings : 8:30 - 10AM Sept. - Mar. Wednesday Evenings : 6:15-7:45PM Sept. - Mar.
Grade 9 - 12 choices: (check all that apply )	9th Grade High School Religious Education CTM (9-12)
Any special learning issues, allergies, or medical conditions:
	Please include this student in group text messaging for class reminders, cancellations, service opportunities, etc. using this cell number:

Student Information (Second Student)
Full Name:
Date of Birth:
Grade in School in Fall:
School Attending in Fall:
Baptism:	At ICC/St. Jude Other Parish If child was baptized at another parish and we do not have your records already, you must submit a copy of his/her Baptismal Certificate with your registration.
Sacraments already received:	Reconciliation First Eucharist Confirmation
Sacraments to be received this year:	First Reconciliation (Grade 2 and above) First Eucharist (Grade 2 and above) Confirmation (Grade 9 - 12)
Previous Religious Education:	At ICC/St. Jude Other Parish None If child attended a religious education program at another parish last year, you must submit a letter from the parish or Catholic School indicating the grades and years attended and sacraments received with your registration.
Pre-K (age 3-4-5) Session Choice:	3-Year-Old Program: Sunday mornings from 10:15 - 11:30AM Sept. - May 4-Year-Old Program: Sunday mornings from 10:15 - 11:30AM Sept. - May Kindergarten Program: Sunday mornings from 10:15 - 11:30AM Sept. - May
Grade 1 - 8 Session Choice:	Sunday mornings : 8:30 - 10AM Sept. - Mar. Wednesday Evenings : 6:15-7:45PM Sept. - Mar.
Grades 9 - 12 choices: (check all that apply )	9th Grade High School Religious Education CTM (9-12)
Any special learning issues, allergies, or medical conditions:
	Please include this student in group text messaging for class reminders, cancellations, service opportunities, etc. using this cell number:

Student Information (Third Student)
Full Name:
Date of Birth:
Grade in School in Fall:
School Attending in Fall:
Baptism:	At ICC/St. Jude Other Parish If child was baptized at another parish and we do not have your records already, you must submit a copy of his/her Baptismal Certificate with your registration.
Sacraments already received:	Reconciliation First Eucharist Confirmation
Sacraments to be received this year:	First Reconciliation (Grade 2 and above) First Eucharist (Grade 2 and above) Confirmation (Grade 9 - 12)
Previous Religious Education:	At ICC/St. Jude Other Parish None If child attended a religious education program at another parish last year, you must submit a letter from the parish or Catholic School indicating the grades and years attended and sacraments received with your registration.
Pre-K (age 3-4-5) Session Choice:	3-Year-Old Program: Sunday mornings from 10:15 - 11:30AM Sept. - May 4-Year-Old Program: Sunday mornings from 10:15 - 11:30AM Sept. - May Kindergarten Program: Sunday mornings from 10:15 - 11:30AM Sept. - May
Grade 1 - 8 Session Choice:	Sunday mornings : 8:30 - 10AM Sept. - Mar. Wednesday Evenings : 6:15-7:45PM Sept. - Mar.
Grades 9 -12 choices: (check all that apply )	9th Grade High School Religious Education CTM (9-12)
Any special learning issues, allergies, or medical conditions:
	Please include this student in group text messaging for class reminders, cancellations, service opportunities, etc. using this cell number:

Student Information (Fourth Student)
Full Name:
Date of Birth:
Grade in School in Fall:
School Attending in Fall:
Baptism:	At ICC/St. Jude Other Parish If child was baptized at another parish and we do not have your records already, you must submit a copy of his/her Baptismal Certificate with your registration.
Sacraments already received:	Reconciliation First Eucharist Confirmation
Sacraments to be received this year:	First Reconciliation (Grade 2 and above) First Eucharist (Grade 2 and above) Confirmation (Grade 9 - 12)
Previous Religious Education:	At ICC/St. Jude Other Parish None If child attended a religious education program at another parish last year, you must submit a letter from the parish or Catholic School indicating the grades and years attended and sacraments received with your registration.
Pre-K (age 3-4-5) Session Choice:	3-Year-Old Program: Sunday mornings from 10:15 - 11:30AM Sept. - May 4-Year-Old Program: Sunday mornings from 10:15 - 11:30AM Sept. - May Kindergarten Program: Sunday mornings from 10:15 - 11:30AM Sept. - May
Grade 1 - 8 Session Choice:	Sunday mornings : 8:30 - 10AM Sept. - Mar. Wednesday Evenings : 6:15-7:45PM Sept. - Mar.
Grades 9 - 12 choices: (check all that apply )	9th Grade High School Religious Education CTM (9-12)
Any special learning issues, allergies, or medical conditions:
	Please include this student in group text messaging for class reminders, cancellations, service opportunities, etc. using this cell number:
Letters will be mailed confirming your program selections in August. Contact the Religious Education Office at 410-392-3551 or re@iccparish.org if you have any questions.