CTK Religious Education Registration - Copy
 
CTK Religious Education Registration - Copy
If you have any questions, or need to register more than 4 children, please contact Deb Frost at dfrost.ctk.re@gmail.com or call the church at 785-273-0710.
Please note this form has required fields, as indicated by a red asterisk. Family information and details for one child are required to complete online registration. If registering more than one child, please complete ALL fields for each additional child.
Family's Last Name:  * 
Mailing Address:  * 
Contact email(s):  * 
Contact Phone Number(s):  * 
Emergency Contact & Phone Number:  * 
Fathers Name:
Mothers Name:
Our family is registered at Christ the King Parish:  * 
Are all children registered authorized for photo release for Parish Bulletin?  * 
Early Registration (until Aug. 8, 2019) cost of the program is $75 for one student; $150 for two students; or $180 for 3 or more students.
Please indicate the number of children you are registering:
Child 1 - Full Name (First, Middle, Last):  * 
Child 1 - Date of Birth:  * 
Child 1 - Male or Female:  * 
Child 1 - Grade:  * 
Child 1 - School:  * 
Child 1 - Sacraments:  * 
Child 1 - Any Special Needs:  * 
Child 1 - Indicate special needs:
Child 1 - Any allergies:  * 
Child 1 - List allergies:
Child 2 - Full Name (First, Middle, Last):
Child 2 - Date of birth:
Child 2 - Male or Female:
Child 2 - Grade:
Child 2 - School:
Child 2 - Sacraments:
Child 2 - Any special needs:
Child 2 - Please note special needs:
Child 2 - Any allergies:
Child 2 - Please list all allergies:
Child 3 - Full Name (First, Middle, Last):
Child 3 - Date of birth:
Child 3 - Male or Female:
Child 3 - Grade:
Child 3 - School:
Child 3 - Sacraments:
Child 3 - Any special needs:
Child 3 - Please indicate special needs:
Child 3 - Allergies:
Child 3 - Detail allergies:
Child 4 - Full Name (First, Middle, Last):
Child 4 - Date of birth:
Child 4 - Male or Female:
Child 4 - Grade:
Child 4 - School:
Child 4 - Sacraments:
Child 4 - Any special needs:
Child 4 - Please detail special needs:
Child 4 - Any allergies:
Child 4 - Please detail allergies:
Please make note of any additional special requests/needs. * 
Your Email Address  * 
Total $
 
 
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