PSR / Senior High Youth Registration Form

PSR / Senior High Youth registration early bird registration is now open for the 2017/2018 school year for returning PSR families. Open enrollment for the upcoming 2017/2018 year will begin May 6.

PSR (Pre-K(4-years-old by August 1)-8th Grade) and Senior High Sessions Registration Form 2017-18

This form will not send if it is not completely filled out. Please note all fields with an asterisks* are required fields. Please scroll back to the top of the page to view the confirmation message once form has been sent.

*Parent(s) Date

Address City

State Zip

Home Phone Cell Phone *Your Email

*Are you a registered member of the parish?

If you are not registered parishioners and wish to enroll your child in PSR, please stop now and
contact Mindy Lehman for pre-kindergarten (4-years-old by August 1) through grade eight at Mindy@holyfamily.com or 816-436-9200, ext. 61,
or Rob Lickteig for high school students at Rob@holyfamily.com or 816-436-9200, ext. 35.


PSR Registration

Session choices: Sunday 9:45 a.m., Sunday 5:30 p.m. and Monday 5:30 p.m. Please type in both first and second choices.

Name Goes By Birthdate

Grade School First choice Second choice

Name Goes By Birthdate

Grade School First choice Second choice

Name Goes By Birthdate

Grade School First choice Second choice

Name Goes By Birthdate

Grade School First choice Second choice

Senior High Youth Nights

Classes meet on Sunday from 5:30-7 p.m.

Name Goes By Birthdate

Grade School Peer Minister

Name Goes By Birthdate

Grade School Peer Minister

Name Goes By Birthdate

Grade School Peer Minister

Name Goes By Birthdate

Grade School Peer Minister

*Does your child have any health concerns? Please share any important health information regarding allergies (especially to food), diabetes, ADD/ADHD or any other medical or mental health concerns that the teacher should know about in the field below. Include the child's name, followed by the health information.

Sacraments: Please check which sacraments your child has received.

Name

Catholic BaptismNon-Catholic BaptismReconciliationCommunionConfirmation

Name

Catholic BaptismNon-Catholic BaptismReconciliationCommunionConfirmation

Name

Catholic BaptismNon-Catholic BaptismReconciliationCommunionConfirmation

Name

Catholic BaptismNon-Catholic BaptismReconciliationCommunionConfirmation

Please contact me about the sacraments my child(ren) have not yet received.

Please note requirements for sacramental preparation for reconciliation and first Eucharist OR for confirmation:

  • One year of Religious Education immediately prior to receiving Sacrament and
    Sacramental year. Attendance must be at or above 75% for both the year prior and
    year of sacrament in order to continue on the Sacramental track.
  • A copy of your child's baptismal certificate, if not baptized at Holy Family.

*I acknowledge that attendance is mandatory during the year prior and year of Sacramental Preparation for either Reconciliation, First Eucharist or Confirmation.

Stewardship
I can: be a Catechistbe an Aidebe a Sub

For PSR catechist and aide positions: Grade Desired Class session (PSR only)

For senior high positions, mark with X: Catechist Peer Minister (High School Student)

I, *, hereby give my permission for my child(ren) * to participate in religious education at Holy Family Parish.

Please check the boxes below if YES. Leave blank if NO. First three boxes must be checked or your child cannot be accepted into the PSR program.

*I understand there is a risk of injury involved in any activity. I agree that I will not hold the parish, school or organization named above or the Diocese of Kansas City-St. Joseph responsible for any injuries that my child might incur while participating in this event. In an emergency, if I cannot be contacted, I hereby authorize that emergency treatment be administered.

*I understand my said child(ren) need to conduct themselves in a Christian manner at all times while in the custody of the Religious Education Coordinators and while on the grounds of Holy Family Catholic Church. As a family we agree to enforce the respect of church property, the respect of the people leading the religious education and the others peers. We understand if there are problems with rule breaking, it may result in termination of the child(ren) attending the religious education offered at Holy Family Catholic Church.

*I agree to share important information with the Religious Education Coordinators such as allergies or behavioral/emotional disorders to allow us to care for you child(ren) to the best of our abilities.

I give permission for photos and/or video of my child(ren) to be taken for parish use in print and social media.

Parent or Legal Guardian Signature

*Name *Date
*This is my electronic signature.

Fees
1. Payment due at time of registration online through the link at the bottom of this form.
2. We will process your registration only when payment has been received.
3. No one is denied religious formation because of finances; please talk to the director about arrangements.
4. Special activities, retreats, social events and meals may have a fee or cost not included in the base fee.
5. A $50 discount is given to all families in which parents/older siblings volunteer as a catechist/aide. Discount does not apply to sacramental fees.
6. Payment does not include any fees for a student seeking to prepare for sacraments.

Please check the correct box:
$50/1 student $90/2 students $120/3 or more students $25/peer minister $50/2 peer ministers

Questions?

  • For PSR programming (Pre-K-8th grade) or sacraments of reconciliation and first Communion: Mindy Lehman | 816-436-9200, ext. 61 mindy@holyfamily.com
  • For senior high school programming or for the sacrament of confirmation: Rob Lickteig | 816-436-9200, ext 35
    rob@holyfamily.com

Payment due at time of registration online through the payment button at the bottom of this form. If you send in this form but do not pay, your child(ren) will not be enrolled in PSR for the upcoming year.

Please scroll back to the top of the page for sent confirmation.

Pay Online Here
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