- REGISTRATION OPEN 2025-2026 SCHOOL YEAR!
  Welcome Letter
  REGISTRATION FORM
  ***Please return completed form to the address below with your payment (fee discounted if received by June 15th). Thank you!***
  Religious Education Registration
  St. Mary's Parish
  114 Princeton Street
  Jefferson, MA 01522
  
  *Register and pay online today using our online registration form below.
- Religious Education Registraton Form
  
  Submit Payment & form Online Today!
  
  We apologize, the maximum number of form submissions has been reached. This form is currently not available.
  
  Date REQUIRED Please fill out this field. Please enter a date.
  
  Family Name REQUIRED Please fill out this field. Please enter valid data.
  
  Is your family registerd at St. Mary's? REQUIRED Yes No Please fill out this field.
  
  Mother's or Guardian's Name Please enter valid data.
  
  Mother's or Guardian's Email Please enter an email address.
  
  Mother's or Guardian's Home Phone Number Maximum 20 characters Please enter a phone number.
  
  Mother's or Guardian's Cell Phone Number Maximum 20 characters Please enter a phone number.
  
  Mother's or Guardian's Address Please enter valid data.
  
  City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
  
  Father's Name Please enter valid data.
  
  Father's Email Please enter an email address.
  
  Father's Home Phone Number Maximum 20 characters Please enter a phone number.
  
  Father's Cell Phone Number Maximum 20 characters Please enter a phone number.
  
  Father's Address (if different, please complete) Please enter valid data.
  
  City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
  
  # of Children Registering (Please list from oldest to youngest) REQUIRED
  If your child(ren) attends Parochial School, please select "PS, will attend" if attending our program.
  Please fill out this field.
  
  Child 1
  
  Last Religious Ed. Grade Completed as of August this year. REQUIRED Please fill out this field.
  
  Attends Parochial School REQUIRED Yes, Will Attend St. Mary's Program No Does not attend Parochial School Please fill out this field.
  
  Child's Full Name: First, Middle, Last REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Child's City & State of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  School Attending this year REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field.
  
  Class Day Preference REQUIRED Please fill out this field.
  
  Mother's Maiden Name REQUIRED Please fill out this field. Please enter valid data.
  
  Student Email: Middle & High School Students Only Please enter an email address.
  
  Child 2
  
  Last Religious Ed. Grade Completed as of August this year. REQUIRED Please fill out this field.
  
  Attends Parochial School REQUIRED Yes, Will Attend St. Mary's Program No Does not attend Parochial School Please fill out this field.
  
  Child's Full Name: First, Middle, Last REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Child's City & State of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  School Attending this year REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field.
  
  Class Day Preference REQUIRED Please fill out this field.
  
  Mother's Maiden Name REQUIRED Please fill out this field. Please enter valid data.
  
  Student Email: Middle & High School Students Only Please enter an email address.
  
  Child 3
  
  Last Religious Ed. Grade Completed as of August this year. REQUIRED Please fill out this field.
  
  Attends Parochial School REQUIRED Yes, Will Attend St. Mary's Program No Does not attend Parochial School Please fill out this field.
  
  Child's Full Name: First, Middle, Last REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Child's City & State of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  School Attending this year REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field.
  
  Class Day Preference REQUIRED Please fill out this field.
  
  Mother's Maiden Name REQUIRED Please fill out this field. Please enter valid data.
  
  Student Email: Middle & High School Students Only Please enter an email address.
  
  Child 4
  
  Last Religious Ed. Grade Completed as of August this year. REQUIRED Please fill out this field.
  
  Attends Parochial School REQUIRED Yes, Will Attend St. Mary's Program No Does not attend Parochial School Please fill out this field.
  
  Child's Full Name: First, Middle, Last REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Child's City & State of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  School Attending this year REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field.
  
  Class Day Preference REQUIRED Please fill out this field.
  
  Mother's Maiden Name REQUIRED Please fill out this field. Please enter valid data.
  
  Student Email: Middle & High School Students Only Please enter an email address.
  
  Child 5
  
  Last Religious Ed. Grade Completed as of August this year. REQUIRED Please fill out this field.
  
  Attends Parochial School REQUIRED Yes, Will Attend St. Mary's Program No Does not attend Parochial School Please fill out this field.
  
  Child's Full Name: First, Middle, Last REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Child's City & State of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  School Attending this year REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field.
  
  Class Day Preference REQUIRED Please fill out this field.
  
  Mother's Maiden Name REQUIRED Please fill out this field. Please enter valid data.
  
  Student Email: Middle & High School Students Only Please enter an email address.
  
  Child 6
  
  Last Religious Ed. Grade Completed as of August this year. REQUIRED Please fill out this field.
  
  Attends Parochial School REQUIRED Yes, Will Attend St. Mary's Program No Does not attend Parochial School Please fill out this field.
  
  Child's Full Name: First, Middle, Last REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Child's City & State of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  School Attending this year REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field.
  
  Class Day Preference REQUIRED Please fill out this field.
  
  Mother's Maiden Name REQUIRED Please fill out this field. Please enter valid data.
  
  Student Email: Middle & High School Students Only Please enter an email address.
  
  Child 7
  
  Last Religious Ed. Grade Completed as of August this year. REQUIRED Please fill out this field.
  
  Attends Parochial School REQUIRED Yes, Will Attend St. Mary's Program No Does not attend Parochial School Please fill out this field.
  
  Child's Full Name: First, Middle, Last REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Child's City & State of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  School Attending this year REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field.
  
  Class Day Preference REQUIRED Please fill out this field.
  
  Mother's Maiden Name REQUIRED Please fill out this field. Please enter valid data.
  
  Student Email: Middle & High School Students Only Please enter an email address.
  
  Child 8
  
  Last Religious Ed. Grade Completed as of August this year. REQUIRED Please fill out this field.
  
  Attends Parochial School REQUIRED Yes, Will Attend St. Mary's Program No Does not attend Parochial School Please fill out this field.
  
  Child's Full Name: First, Middle, Last REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Child's City & State of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  School Attending this year REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field.
  
  Class Day Preference REQUIRED Please fill out this field.
  
  Mother's Maiden Name REQUIRED Please fill out this field. Please enter valid data.
  
  Student Email: Middle & High School Students Only Please enter an email address.
  
  Child 9
  
  Last Religious Ed. Grade Completed as of August this year. REQUIRED Please fill out this field.
  
  Attends Parochial School REQUIRED Yes, Will Attend St. Mary's Program No Does not attend Parochial School Please fill out this field.
  
  Child's Full Name: First, Middle, Last REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Child's City & State of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  School Attending this year REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field.
  
  Class Day Preference REQUIRED Please fill out this field.
  
  Mother's Maiden Name REQUIRED Please fill out this field. Please enter valid data.
  
  Student Email: Middle & High School Students Only Please enter an email address.
  
  Child 10
  
  Last Religious Ed. Grade Completed as of August this year. REQUIRED Please fill out this field.
  
  Attends Parochial School REQUIRED Yes, Will Attend St. Mary's Program No Does not attend Parochial School Please fill out this field.
  
  Child's Full Name: First, Middle, Last REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Child's City & State of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  School Attending this year REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field.
  
  Class Day Preference REQUIRED Please fill out this field.
  
  Mother's Maiden Name REQUIRED Please fill out this field. Please enter valid data.
  
  Student Email: Middle & High School Students Only Please enter an email address.
  
  Child 11
  
  Last Religious Ed. Grade Completed as of August this year. REQUIRED Please fill out this field.
  
  Attends Parochial School REQUIRED Yes, Will Attend St. Mary's Program No Does not attend Parochial School Please fill out this field.
  
  Child's Full Name: First, Middle, Last REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Child's City & State of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  School Attending this year REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field.
  
  Class Day Preference REQUIRED Please fill out this field.
  
  Mother's Maiden Name REQUIRED Please fill out this field. Please enter valid data.
  
  Student Email: Middle & High School Students Only Please enter an email address.
  
  Child 12
  
  Last Religious Ed. Grade Completed as of August this year. REQUIRED Please fill out this field.
  
  Attends Parochial School REQUIRED Yes, Will Attend St. Mary's Program No Does not attend Parochial School Please fill out this field.
  
  Child's Full Name: First, Middle, Last REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Child's City & State of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  School Attending this year REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field.
  
  Class Day Preference REQUIRED Please fill out this field.
  
  Mother's Maiden Name REQUIRED Please fill out this field. Please enter valid data.
  
  Student Email: Middle & High School Students Only Please enter an email address.
  
  Are you registering any child for the first time? REQUIRED Yes No Please fill out this field.
  
  * If Yes, a copy of your child's Baptismal Certificate must be received by September 1st.
  
  Registration Fee Overview: Please make you selections below.
  
  *Early Registration Fee (if received by June 15th):
  $85.00 per child/$230.00 max per family
  
  *Registration Fee (After June 15th):
  $95.00 per child/$250.00 max per family
  
  *Please Note: Grade 11 students are required to register and submit payment as usual.
  
  *Additional Fees:
  -Gr. 2 please add $50.00 per child for:
  First Reconciliation/First Eucharist/ Sacramental Prep Resources & Retreat.
  
  -Gr. 10 please add $60.00 per child for:
  Pre-Confirmation Prep & Retreat.
  
  Registration Fees are due for Parochial School Students when preparing for sacraments. Please check the amount(s) that makes up the total payment to be received by the office.
  
  REGISTRATION PAYMENT(S), PLEASE MAKE YOUR SECTION(S) BELOW:
  
  Religious Education Tuition - Required REQUIRED Please fill out this field.
  
  *Additional Fee - GRADE 2 ONLY (First Reconciliation/First Eucharist/ Sacramental Prep Resources & Retreat)
  50.0 – Grade 2, Child 1
  50.0 – Grade 2, Child 2
  50.0 – Grade 2, Child 3
  
  *Additional Fee - GRADE 10 ONLY (Pre-Confirmation Prep & Retreat.)
  60.0 – Grade 10, Child 1
  60.0 – Grade 10, Child 2
  60.0 – Grade 10, Child 3
  
  EMERGENCY NOTIFICATION INFORMATION:
  
  WHERE CAN YOU BE REACHED DURING CLASS TIME?
  
  Emergency Contact: First, Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  WHO CAN CARE FOR YOUR CHILD(REN) IF WE CAN'T REACH YOU?
  
  Secondary Emergency Contact: First, Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  CHILD(REN) PHYSICIAN INFORMATION:
  
  Child(ren) Physician (if more than one select the number below) REQUIRED Please fill out this field.
  
  Child(ren) 1
  
  Child(rens) Name(s) REQUIRED Please fill out this field. Please enter valid data.
  
  Physician REQUIRED Please fill out this field. Please enter valid data.
  
  Physician Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Child(ren) 2
  
  Child(rens) Name(s) REQUIRED Please fill out this field. Please enter valid data.
  
  Physician REQUIRED Please fill out this field. Please enter valid data.
  
  Physician Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Child(ren) 3
  
  Child(rens) Name(s) REQUIRED Please fill out this field. Please enter valid data.
  
  Physician REQUIRED Please fill out this field. Please enter valid data.
  
  Physician Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Child(ren) 4
  
  Child(rens) Name(s) REQUIRED Please fill out this field. Please enter valid data.
  
  Physician REQUIRED Please fill out this field. Please enter valid data.
  
  Physician Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Child(ren) 5
  
  Child(rens) Name(s) REQUIRED Please fill out this field. Please enter valid data.
  
  Physician REQUIRED Please fill out this field. Please enter valid data.
  
  Physician Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Child(ren) 6
  
  Child(rens) Name(s) REQUIRED Please fill out this field. Please enter valid data.
  
  Physician REQUIRED Please fill out this field. Please enter valid data.
  
  Physician Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Child(ren) 7
  
  Child(rens) Name(s) REQUIRED Please fill out this field. Please enter valid data.
  
  Physician REQUIRED Please fill out this field. Please enter valid data.
  
  Physician Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Child(ren) 8
  
  Child(rens) Name(s) REQUIRED Please fill out this field. Please enter valid data.
  
  Physician REQUIRED Please fill out this field. Please enter valid data.
  
  Physician Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Child(ren) 9
  
  Child(rens) Name(s) REQUIRED Please fill out this field. Please enter valid data.
  
  Physician REQUIRED Please fill out this field. Please enter valid data.
  
  Physician Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Child(ren) 10
  
  Child(rens) Name(s) REQUIRED Please fill out this field. Please enter valid data.
  
  Physician REQUIRED Please fill out this field. Please enter valid data.
  
  Physician Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Child(ren) 11
  
  Child(rens) Name(s) REQUIRED Please fill out this field. Please enter valid data.
  
  Physician REQUIRED Please fill out this field. Please enter valid data.
  
  Physician Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Child(ren) 12
  
  Child(rens) Name(s) REQUIRED Please fill out this field. Please enter valid data.
  
  Physician REQUIRED Please fill out this field. Please enter valid data.
  
  Physician Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  HOW CAN YOU HELP? Please try to find at least one way that you can assist. We can't run our program without you!
  
  Volunteer's Name Please enter valid data.
  
  Volunteer's Daytime Phone Number Maximum 20 characters Please enter a phone number.
  
  Volunteer's Email Please enter an email address.
  
  I will help with...
  
  I VOLUNTEER TO TEACH CLASS
  
  I VOLUNTEER TO SUBSTITUTE
  
  I VOLUNTEER TO SERVE AS A CLASSROOM AIDE FOR A CHILD WHO NEEDS ASSISTANCE
  
  ON SITE CHILD CARE:
  
  I volunteer to be On Site for Teachers' Small Children During Class Time
  
  I volunteer to be On Site for Parent' Small Children During: Evening Meetings Yes No
  
  I volunteer to be On Site for Parent's Small Children During Weekend Retreats Yes No
  
  MAKE PHONE CALLS:
  
  Volunteer's Day(s) and Time(s) to make calls
  
  PROVIDE OFFICE/DAYTIME HELP Monday Morning Monday Afternoon Tuesday Morning Tuesday Afternoon Wednesday Morning Wednesday Afternoon Other
  
  Volunteer's Day(s) Times(s) to provide office help Please enter valid data.
  
  OTHER WAYS TO HELP...
  
  HOW CAN WE HELP YOU? Is there any special need (Learning, Social, Allergies, Health, Etc...?) THAT WE SHOULD BE AWARE OF, SO THAT WE CAN BEST SERVE YOUR CHILD(REN)? Please List specifics:
  
  Email Form REQUIRED Please fill out this field. Please enter an email address.
  
  Total:
  
  Submit
  
  Proceed to Payment
  
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