Religious Education Registration Form - Church of the Resurrection

Religious Education Program (CCD) 2024-2025 Registration

In Person Class Time Weekly: Monday: K-HS: 6:00 pm - 7:15 pm.
Helene Stever, Director of Religious Education
301-288-4664 | hstever@resurrectionadw.org
Religious Education Class does not replace weekly Mass attendance, children are expected to attend weekly Mass.

A separate registration form for each child is required. First time registrant must provide a copy of Baptism, First Eucharist and Confirmation certificate as applicable. Complete this form with tuition payment by September 15, 2024.
Note: Child is not placed into the class until payment is received.
Family Information
Returning Student?
- Yes
- No
Family Last Name*
Home Phone*
Email*

Preferred Address for Correspondence
Family Residence Address*
Street Address Address Line 2 City State ZIP Code
Mother's Information
Mother's Name
First Last
Email
Cell Phone
Work Phone
Occupation
Religion
Marital Status
Maiden Name
Father's Information
Father's Name*
First Last
Email
Cell Phone
Work Phone
Occupation
Religion
Marital Status
Student's Information (as of September 1, 2024)
Name*
First Middle Last
Gender*
Age*
Date of Birth*
Month
Day
Year
Place of Birth (hospital, City, State)
Academic School*
Grade*
Where did student attend Religious Ed classes last year?*
Student lives with*
Pick Up Authorization
Who is authorized to pick up your child/children from class?*
- Parents Only
- Parents and Others (listed below)
Name of Others Authorized to Pickup*
First Last
Name of Others Authorized to Pickup
First Last
Name of Others Authorized to Pickup
First Last
Signature
Sacraments Child Has Received
Has your child been baptized?*
- Yes
- No
Baptism Date*
Month
Day
Year
Where was the child baptized?*
Church Name City State
Has your child received First Reconciliation?*
- Yes
- No
First Reconciliation Date*
Month
Day
Year
Where did your child receive First Reconciliation??*
Church Name City State
Has your child received First Communion?*
- Yes
- No
First Communion Date*
Month
Day
Year
Where did the child receive First Communion?*
Church Name City State
Emergency Medical Information, Photo/Video or Zoom Online Class Permission
n the event I cannot be reached, I hereby grant permission for my child to be evaluated, diagnosed, treated, and/or medicated in accordance with medical practice by licensed medical personnel. I authorize Resurrection Staff and/or volunteer catechists to provide routine first aid to my child. I give permission for any photographs or video taken of my child at this program to be used on the parish website or with any parish religious education public relations. My child will not be identified by name. Also, I give permission for my child to be taught by an online zoom class if needed during the Religious Education program year.
Printed Name*
Signature
Relationship To Child*
Health,Medical and Special Needs (Educational) Information
Information listed below remains confidential and will only be used for purposes related to assisting the catechist.
List of any chronic health conditions,recent/current serious illness or injury.
List any food/environment allergies.
List any medications the child is currently taking.
List any educational or behavioural needs (e.g. gifted,dyslexic,ADD,slow reader, etc.)
Payment Information
Are you a registered parishioner?*
- Yes
- No
If yes, what is your envelope/parish registration number?*
If no, in what parish are you registered?*
Tuition*
- In person classes, $125
- At home teaching with book/online videos. Quarterly evaluations, $50
Sacramental Preparation Fee (in addition to tuition)*
- $100 for First Eucharist/RCIC
- $100 for Confirmation/RCIC
- N/A
If your student is receiving the sacrament of First Eucharist or Confirmation, you must pay a Sacramental Preparation Fee at the time of the registration or by the first parent meeting held in the Fall.
For out of parish tuition: Additional $25.00 per child.
Price:
Total Amount Due for this Child
$0.00
Please select a payment method:*
- Credit Card (online)
- Check/Cash (at the office)
Payment by check/cash must be made at the office on or before September 15.
Credit Card*
Card Details
Cardholder Name
By my signature below, I grant permission for my child/ren, to participate in Church of the Resurrection, Burtonsville, MD, Religious Education Program under the guidance and direction of parish employees and/or volunteers from Church of the Resurrection, Burtonsville, MD.

The 2024-2025 Religious Education Program year will include sessions offered through an online platform. This activity will take place under the guidance and direction of parish employees and/or volunteers who are subject to the Archdiocese of Washington’s Child Protection and Safe Environment Policy. I will be notified of the sessions and how they will be conducted, including registration links should I want to be present with my child. I understand that, as parent and/or legal guardian, I remain legally responsible for any actions taken by my child (listed above). My child agrees to abide by all rules and regulations outlined for participation in the program, including all rules and regulations outlined for any online session(s).  I understand and agree that the Office for Catechesis, the Archdiocese of Washington, and Church of the Resurrection, Burtonsville, MD, will not be held liable if my child fails to cooperate with said regulations and that any infractions of the rules may result in immediate dismissal from the activity.

Permission is hereby granted to Church of the Resurrection, Burtonsville, MD, to use the photographs of and/or quotations from my son/daughter to assist in community awareness, educational efforts, and related public relations efforts that may include brochures, posters, website, and print media.
*
- I agree with this policy
- I am the legal parent or legal guardian of the child(ren) and I certify that the information contained on this form is correct.
Signature of Parent or Legal Guardian
Name*
Enter the full name of the person completing this form and agreeing to the terms above.
Comments
This field is for validation purposes and should be left unchanged.

Religious Education Program (CCD) 2024-2025 Registration

Family Information

Mother's Information

Father's Information

Student's Information (as of September 1, 2024)

Pick Up Authorization

Sacraments Child Has Received

Emergency Medical Information, Photo/Video or Zoom Online Class Permission

Health,Medical and Special Needs (Educational) Information

Payment Information