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Immaculate Conception Catholic CHurch
St. Mary - Hallettsville, TX
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Home
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Contact Us
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Religious Education
Religious Education
Formed.org
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Events & News
Stay Connected
Picnic
Calendar
Events
News
Photo Albums
Religious Education
Religious Education
Religious Education
Forms
Retreats
Formed.org
Becoming Catholic
Retreats & Conferences
Religious Education
Every Wednesday 6:00 p.m. - 7:00 p.m.
Contact Us
Carol Rother
Religious Education Director
361-798-6856
rother.carol
gmail.com
Religious Education Registration
Parent 1
*
First Name
*
Maximum 80 characters
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Please enter valid data.
Last Name
*
Maximum 80 characters
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Please enter valid data.
Family Contact Email
*
Maximum 200 characters
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Please enter an email address.
Family Phone
*
Maximum 20 characters
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Please enter a phone number.
Parent 2
First Name
Maximum 80 characters
Please enter valid data.
Last Name
Maximum 80 characters
Please enter valid data.
Email
Maximum 200 characters
Please enter an email address.
Phone
Maximum 20 characters
Please enter a phone number.
Emergency Contact
*
First Name
*
Maximum 80 characters
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Please enter valid data.
Last Name
*
Maximum 80 characters
Please fill out this field.
Please enter valid data.
Phone
*
Maximum 20 characters
Please fill out this field.
Please enter a phone number.
How many children are you registering?
Maximum 10 characters
Please enter an integer (number) from 1 to 10.
Child 1
*
First Name
*
Maximum 80 characters
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Please enter valid data.
Last Name
*
Maximum 80 characters
Please fill out this field.
Please enter valid data.
Date of Birth
*
Maximum 20 characters
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Please enter a date.
Registering for
*
Select Grade
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Comments
Child 2
*
First Name
*
Maximum 80 characters
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Please enter valid data.
Last Name
*
Maximum 80 characters
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Please enter valid data.
Date of Birth
*
Maximum 20 characters
Please fill out this field.
Please enter a date.
Registering for
*
Select Grade
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Kindergarten
1st Grade
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Comments
Child 3
*
First Name
*
Maximum 80 characters
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Please enter valid data.
Last Name
*
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Please enter valid data.
Date of Birth
*
Maximum 20 characters
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Please enter a date.
Registering for
*
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Kindergarten
1st Grade
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5th Grade
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7th Grade
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Comments
Child 4
*
First Name
*
Maximum 80 characters
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Please enter valid data.
Last Name
*
Maximum 80 characters
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Please enter valid data.
Date of Birth
*
Maximum 20 characters
Please fill out this field.
Please enter a date.
Registering for
*
Select Grade
Preschool
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
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7th Grade
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12th Grade
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Comments
Child 5
*
First Name
*
Maximum 80 characters
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Please enter valid data.
Last Name
*
Maximum 80 characters
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Please enter valid data.
Date of Birth
*
Maximum 20 characters
Please fill out this field.
Please enter a date.
Registering for
*
Select Grade
Preschool
Kindergarten
1st Grade
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7th Grade
8th Grade
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12th Grade
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Comments
Child 6
*
First Name
*
Maximum 80 characters
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Please enter valid data.
Last Name
*
Maximum 80 characters
Please fill out this field.
Please enter valid data.
Date of Birth
*
Maximum 20 characters
Please fill out this field.
Please enter a date.
Registering for
*
Select Grade
Preschool
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
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Comments
Child 7
*
First Name
*
Maximum 80 characters
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Please enter valid data.
Last Name
*
Maximum 80 characters
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Please enter valid data.
Date of Birth
*
Maximum 20 characters
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Please enter a date.
Registering for
*
Select Grade
Preschool
Kindergarten
1st Grade
2nd Grade
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4th Grade
5th Grade
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7th Grade
8th Grade
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11th Grade
12th Grade
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Comments
Child 8
*
First Name
*
Maximum 80 characters
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Please enter valid data.
Last Name
*
Maximum 80 characters
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Please enter valid data.
Date of Birth
*
Maximum 20 characters
Please fill out this field.
Please enter a date.
Registering for
*
Select Grade
Preschool
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Please fill out this field.
Comments
Child 9
*
First Name
*
Maximum 80 characters
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Please enter valid data.
Last Name
*
Maximum 80 characters
Please fill out this field.
Please enter valid data.
Date of Birth
*
Maximum 20 characters
Please fill out this field.
Please enter a date.
Registering for
*
Select Grade
Preschool
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Please fill out this field.
Comments
Child 10
*
First Name
*
Maximum 80 characters
Please fill out this field.
Please enter valid data.
Last Name
*
Maximum 80 characters
Please fill out this field.
Please enter valid data.
Date of Birth
*
Maximum 20 characters
Please fill out this field.
Please enter a date.
Registering for
*
Select Grade
Preschool
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
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