PSR Registration

# of Children attending PSR REQUIRED Please fill out this field.
Child 1
- Name REQUIRED Please fill out this field. Please enter valid data.
- Gender REQUIRED Please fill out this field.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Sacraments Received REQUIRED Baptism 1st Reconciliation 1st Communion Confirmation Please fill out this field.
- Sacrament Details REQUIRED
  Please record all sacramental dates for your child according to their baptismal certificate
  Please fill out this field.
- For all sacraments not received at St. Monica, please send a copy of the baptismal certificate with all sacraments received to [email protected]
- Check this box once you have sent the email or all sacraments received are at St. Monica. REQUIRED Email Sent/All St. Monica Sacraments Please fill out this field.
Child 2
- Name REQUIRED Please fill out this field. Please enter valid data.
- Gender REQUIRED Please fill out this field.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Sacraments Received REQUIRED Baptism 1st Reconciliation 1st Communion Confirmation Please fill out this field.
- Sacrament Details REQUIRED
  Please record all sacramental dates for your child according to their baptismal certificate
  Please fill out this field.
- For all sacraments not received at St. Monica, please send a copy of the baptismal certificate with all sacraments received to [email protected]
- Check this box once you have sent the email or all sacraments received are at St. Monica. REQUIRED Email Sent/All St. Monica Sacraments Please fill out this field.
Child 3
- Name REQUIRED Please fill out this field. Please enter valid data.
- Gender REQUIRED Please fill out this field.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Sacraments Received REQUIRED Baptism 1st Reconciliation 1st Communion Confirmation Please fill out this field.
- Sacrament Details REQUIRED
  Please record all sacramental dates for your child according to their baptismal certificate
  Please fill out this field.
- For all sacraments not received at St. Monica, please send a copy of the baptismal certificate with all sacraments received to [email protected]
- Check this box once you have sent the email or all sacraments received are at St. Monica. REQUIRED Email Sent/All St. Monica Sacraments Please fill out this field.
Child 4
- Name REQUIRED Please fill out this field. Please enter valid data.
- Gender REQUIRED Please fill out this field.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Sacraments Received REQUIRED Baptism 1st Reconciliation 1st Communion Confirmation Please fill out this field.
- Sacrament Details REQUIRED
  Please record all sacramental dates for your child according to their baptismal certificate
  Please fill out this field.
- For all sacraments not received at St. Monica, please send a copy of the baptismal certificate with all sacraments received to [email protected]
- Check this box once you have sent the email or all sacraments received are at St. Monica. REQUIRED Email Sent/All St. Monica Sacraments Please fill out this field.
Child 5
- Name REQUIRED Please fill out this field. Please enter valid data.
- Gender REQUIRED Please fill out this field.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Sacraments Received REQUIRED Baptism 1st Reconciliation 1st Communion Confirmation Please fill out this field.
- Sacrament Details REQUIRED
  Please record all sacramental dates for your child according to their baptismal certificate
  Please fill out this field.
- For all sacraments not received at St. Monica, please send a copy of the baptismal certificate with all sacraments received to [email protected]
- Check this box once you have sent the email or all sacraments received are at St. Monica. REQUIRED Email Sent/All St. Monica Sacraments Please fill out this field.

Parent's Contact Information

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Email REQUIRED Please fill out this field. Please enter an email address.

Subscribe to receive messages about PSR

Emergency Contact Information

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.
Email Please enter an email address.
Subscribe to receive emergency messages about PSR (inclement weather cancellations, safety concerns, etc.)
Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
Relation to Child
Registration Cost REQUIRED 125.0 – 1 Child 175.0 – 2 Children 200.0 – 3 Children 250.0 – 4+ Children Please fill out this field.
The above information is true and is submitted to the best of my ability. If any information is incorrect, I agree to an additional $50 charge.
I Agree Please select this field.

St. Monica Catholic Church
& Preschool

City, ST

PSR Registration

PSR Registration 25-26