St. Mary Magdalen Religious Education - Registration
Religious Ed Apple
Registration consists of three steps:
  1. Complete the form
  2. Send the completed form to the office via email
  3. Complete payment or request scholarship
Step 1

Family Information


(Please enter the cell number for text notifications)
Children live with
Father's First Name
Father's Last Name
Father's Cell
Mother's First Name
Mother's Last Name
Maiden Name
Mother's Cell
Mailing Address
City
Zip Code
Email Address
Emergency Name
Relation
Emergency Cell
Preferred language for mailings:

Child 1 Information

First Name
Middle Name
Last Name
Nickname
Date of Birth
Place of Birth
School Name
Grade
Please note special learning, social or medical needs.
Check completed sacraments:
If you are new to our program, please complete the Sacrament information for each received:
Date Parish Parish Address
Baptism
First Communion
Confirmation

Child 2 Information

First Name
Middle Name
Last Name
Nickname
Date of Birth
Place of Birth
School Name
Grade
Please note special learning, social or medical needs.
Check completed sacraments:
If you are new to our program, please complete the Sacrament information for each received:
Date Parish Parish Address
Baptism
First Communion
Confirmation

Child 3 Information

First Name
Middle Name
Last Name
Nickname
Date of Birth
Place of Birth
School Name
Grade
Please note special learning, social or medical needs.
Check completed sacraments:
If you are new to our program, please complete the Sacrament information for each received:
Date Parish Parish Address
Baptism
First Communion
Confirmation

As parent or legal guardian I do herby consent, authorize, and grant permission to the Diocese of Orlando, Orlando, FL, its agents, employees or duly authorized representatives to take photographs or video of said child and do further consent to the publication, circulation and dissemination of said photographs or video or any duplication or facsimiles thereof for any purposes it may deem proper.

In granting such permission, I hereby relinquish and give to the Diocese of Orlando, Orlando, Florida all right, title and interest I may have in the finished pictures, negatives, reproductions or copies, and further waive any and all right to approve the use of such photographs or video and so release any and all claims of any nature whatsoever arisen for their use.

Permission:
(Child 1, Name)
Permission:
(Child 2, Name)
Permission:
(Child 3, Name)
Parent Signature
Date
Step 2
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