Religious Education

Child #1 Full Name REQUIRED Please fill out this field. Please enter valid data.

Child #1 Birthdate REQUIRED Please fill out this field. Please enter valid data.

Grade REQUIRED Please fill out this field.

Gender REQUIRED Please fill out this field.

School Attends REQUIRED Please fill out this field. Please enter valid data.

Has child #1 been Baptized REQUIRED Yes No Please fill out this field.

Baptismal Church Please enter valid data.

Child #1 Cell Number Please enter valid data.

Child #1 Email Address Please enter valid data.

Please list any allergies or health information staff should be aware of. REQUIRED Please fill out this field.

Child #2 Full Name Please enter valid data.

Child #2 Birthdate Please enter valid data.

Gender

Grade

School Attends Please enter valid data.

Has child #2 been Baptized Yes No

Baptismal Church Please enter valid data.

Student #2 Cell Number Please enter valid data.

Student #2 Email Address Please enter valid data.

Please list any allergies or health information staff should be aware of.

Child #3 Full Name Please enter valid data.

Child #3 Birthdate Please enter valid data.

Gender

Grade

School Attends Please enter valid data.

Has child #3 been Baptized Yes No

Baptismal Church Please enter valid data.

Child #3 Cell Number Please enter valid data.

Child #3 Email Address Please enter valid data.

Please list any allergies or health information staff should be aware of.

Family Mailing Address REQUIRED Please fill out this field. Please enter valid data.

Birth Father Full Name REQUIRED Please fill out this field. Please enter valid data.

Father Cell Number REQUIRED Please fill out this field. Please enter valid data.

Father Email Address REQUIRED Please fill out this field. Please enter valid data.

Birth Mother Full Name REQUIRED Please fill out this field. Please enter valid data.

Mother Cell Number REQUIRED Please fill out this field. Please enter valid data.

Mother Email Address REQUIRED Please fill out this field. Please enter valid data.

Marital Status REQUIRED Please fill out this field.

Children Live With REQUIRED Please fill out this field.

Step Parent Name Please enter valid data.

Step Parent Cell Number Please enter valid data.

Step Parent Email Address Please enter valid data.

More Contact Information

Which Parish/Church is your family registered at REQUIRED Please fill out this field. Please enter valid data.

Emergency Contact (Not Parents) REQUIRED Please fill out this field. Please enter valid data.

Emergency Contact - Relationship REQUIRED Please fill out this field. Please enter valid data.

Emergency Contact - Cell Phone Number REQUIRED Please fill out this field. Please enter valid data.

Emergency Contact #2 (Not Parents) REQUIRED Please fill out this field. Please enter valid data.

Emergency Contact #2 - Relationship REQUIRED Please fill out this field. Please enter valid data.

Emergency Contact #2 - Cell Phone Number REQUIRED Please fill out this field. Please enter valid data.

PERMISSION FORM & MEDICAL RELEASE:
I hereby consent to participation by my son/daughter in Religious Education Activities from August 1, 2026-August 31, 2027 sponsored by Immaculate Conception Catholic Church, St. Mary's. I understand that my son/daughter will be under supervision of parish personnel, volunteers and trained youth. As parent or legal guardian I agree to defend, indemnify and hold harmless Immaculate Conception Catholic Church, St. Mary's and the Diocese of Victoria, its’ clergy, officers, agents, employees and volunteers from any claims, cost or expenses for property damages, personal injuries or other damages arising out of my son/daughter’s participation in the above mentioned activity or during transport to and from the event. I grant permission routine non-surgical medical care to be given to my son/daughter if deemed advisable by the supervising Religious Education personnel. In case of an emergency, I also grant permission to transport my child to the nearest hospital for emergency medical or surgical treatment and for an authorized adult sponsor to sign for treatment if I cannot be located.

Permission Form & Medical Release CONSENT REQUIRED Yes No Please fill out this field.

VIDEO, PHOTO, MEDIA & AUDIO RELEASE
I hereby give permission for my son/daughter to be photographed or video taped. I realize that the photo maybe published in the newspaper, a magazine, or other publication. The video may be used for educational purposes or informational purposes regarding programs or curriculum.

VIDEO, AUDIO, MEDIA & AUDIO CONSENT REQUIRED Yes No Please fill out this field.

TECHNOLOGY RELEASE
Permission to communicate via social media or other electronic communications with a minor must be obtained. Parents must be notified of the methods of communication, which are used in each particular ministry and must be copied and included in such communications. St. Mary's will be using texting, group text apps, email, Facebook and phones to communicate with students and parents. The viewing and use of the online Formed.com videos may be used in class or assigned as extra class work.

TECHNOLOGY CONSENT REQUIRED Yes No Please fill out this field.

Immaculate Conception Catholic CHurch

St. Mary - Hallettsville, TX

Religious Education

Religious Education

Every Wednesday 6:00 p.m. - 7:00 p.m.

Student Registration

Before you submit your form, please read our registration fees & information and policies tab.