St. Jane Frances de Chantal
Catholic Church

8499 Virginia Ave.
Riviera Beach, Maryland 21122

www.stjane.org

www.stjane.org

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Monthly Enrichment Registration Form 2020-21

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St. Jane Frances Family Faith Formation
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- Sign Up
  
  Through July 10: 1 Child = $80/ 2 or more children = $150
  July11-August 15: 1 Child = $90/ 2 or more children = $170
  After August 16: 1 Child = $100/ 2 or more children = $190*
  Additional $20 will be added after September 2nd
- Who is filling out this form? REQUIRED Please fill out this field.
- If "Other" please specify: Please enter valid data.
- Number of Children on this form: REQUIRED Please fill out this field.
- Volunteering at ME Time REQUIRED I would like to help as a Catechist (100% Discount) I would like to help as an Aide in the classroom (50% Discount) I am unable to help at this time Please fill out this field.
- Are you filling out this form after Sept. 2nd? REQUIRED
  Please note that after Sept. 2nd there is a $20 late charge
  Please fill out this field.
- Parent/Gaurdian #1
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Street Address REQUIRED Please fill out this field. Please enter valid data.
- City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Phone Number REQUIRED Please fill out this field. Please enter a phone number.
- Religion REQUIRED Please fill out this field. Please enter valid data.
- Parent/Gaurdian #2
- Who else is responsible for the child/children?
- Street Address Please enter valid data.
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
- Email Please enter an email address.
- Phone Number Please enter a phone number.
- Religion Please enter valid data.
- Child 1 Information
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Grade entering in the fall: REQUIRED Please fill out this field.
- Date of Baptism REQUIRED Please fill out this field. Please enter valid data.
- Place of Baptism (Church, Street Address, City, State, Zip) REQUIRED Please fill out this field.
- Received 1st Eucharist: REQUIRED Yes No Please fill out this field.
- Place of 1st Eucharist (if applicable)
- Child 2 Information
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- Grade entering in the fall:
- Date of Baptism Please enter valid data.
- Place of Baptism (Church, Street Address, City, State, Zip)
- Received 1st Eucharist: Yes No
- Place of 1st Eucharist (if applicable)
- Child 3 Information
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- Grade entering in the fall:
- Date of Baptism Please enter valid data.
- Place of Baptism (Church, Street Address, City, State, Zip)
- Received 1st Eucharist: Yes No
- Place of 1st Eucharist (if applicable)
- If this is your first time registering for our parish religious education program, we need a copy of your child’s baptismal certificate. You may scan and email to chorvath@stjane.org or mail a copy to St. Jane Frances Religious Education 8499 Virginia Ave. 21122.
- Is there anything that we should know to best accomodate your child (Special Accomodations, allergies, etc.)?
- In the interest of promoting and chronicling activities,St. Jane Frances often records events and activities with video, photographs, or other media. Material may be used in print, at meetings, or on the parish website or on the Parish facebook page . The security of the youth is our top priority. No personal information will ever be included in any of the material. By participating in Religious Education at St. Jane Frances, you are acknowleding that you understand.
- I Agree Please select this field.
- Payment must be recieved before registration is accepted in the Parish Office. If you are a Catechist, a payment page, would not come up for you since the fees are waved.
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Monthly Enrichment Registration Form 2020-21

St. Jane Frances Family Faith Formation

Through July 10: 1 Child = $80/ 2 or more children = $150 July11-August 15: 1 Child = $90/ 2 or more children = $170 After August 16: 1 Child = $100/ 2 or more children = $190*

Through July 10: 1 Child = $80/ 2 or more children = $150
July11-August 15: 1 Child = $90/ 2 or more children = $170
After August 16: 1 Child = $100/ 2 or more children = $190*