2024-2025 SRRE Registration

- Faith Formation

Religious Education Registration Form
The maximum number of form submissions has been reached. This form is currently not available.
- Today's Date REQUIRED Please fill out this field. Please enter a date.
- Are you a registered member of St. Raphael? If not, please list the name of the parish where you are registered. REQUIRED Please fill out this field. Please enter valid data.
- Number of Children You Wish to Register REQUIRED Please fill out this field.
  
  Child 1
  
  Child First Name (no nicknames please) REQUIRED Please fill out this field. Please enter valid data.
  
  Child Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Child Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Child Birth Date REQUIRED Please fill out this field. Please enter a date.
  
  Place of Birth (City & State) REQUIRED Please fill out this field. Please enter valid data.
  
  Child Gender REQUIRED Please fill out this field.
  
  Preferred Day and Time for Class (select only one) REQUIRED Sundays, 7:05 - 8:20 p.m. – Grades 2 - 8 + Youth Group Mondays, 4:30 - 5:45  p.m. - Grades K - 8 Mondays, 7:00 - 8:15 p.m. – Grades 1 - 12 Family Catechesis, six Sundays at 4:30, Grades K - 8 Please fill out this field.
  
  Please note: The schedule of in-person classes may change, depending on the availability of volunteer catechists for the various grade levels.
  
  Has the child been baptized? REQUIRED Please fill out this field.
  
  If you answered YES, please fill out the fields below and bring a copy of the baptismal certificate to the SRRE office (unless we already have one on file.)
  If you don't remember the correct date, please write "Can't Remember."
  If you answered NO, please write: "Tentative Baptismal Date _Mo_/_Day_/_Yr_" and write N/A in the remaining church fields.
  
  Date of Baptism - Month/Day/Year (required even if baptized at St. Raphael) Please enter valid data.
  
  Baptismal Church REQUIRED Please fill out this field. Please enter valid data.
  
  Street Address REQUIRED Please fill out this field. Please enter valid data.
  
  City and State (or foreign country) REQUIRED Please fill out this field. Please enter valid data.
  
  ZIP Code Please enter valid data.
  
  Has the child already received Communion? REQUIRED Please fill out this field.
  
  Has the child already received Confirmation? REQUIRED Please fill out this field.
  
  Grade in School September 2024 REQUIRED Please fill out this field.
  
  School attending in September 2024 REQUIRED Please fill out this field. Please enter valid data.
  
  Special Circumstances. In the field below, please let us know if there are any special circumstances that could affect your child learning and participation in our classes and that we should know of (for ex.: Allergies, learning and other disabilities, marital or custody issues, etc.) This information is kept strictly confidential.
  
  Special Circumstances
  
  Child 4
  
  Child First Name (no nicknames please) REQUIRED Please fill out this field. Please enter valid data.
  
  Child Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Child Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Child Birth Date REQUIRED Please fill out this field. Please enter a date.
  
  Place of Birth (City & State) REQUIRED Please fill out this field. Please enter valid data.
  
  Child Gender REQUIRED Please fill out this field.
  
  Preferred Day and Time for Class (select only one) REQUIRED Sundays, 7:05 - 8:20 p.m. – Grades 2 - 8 + Youth Group Mondays, 4:30 - 5:45  p.m. - Grades K - 8 Mondays, 7:00 - 8:15 p.m. – Grades 1 - 12 Family Catechesis, six Sundays at 4:30, Grades K - 8 Please fill out this field.
  
  Please note: The schedule of in-person classes may change, depending on the availability of volunteer catechists for the various grade levels.
  
  Has the child been baptized? REQUIRED Please fill out this field.
  
  If you answered YES, please fill out the fields below and bring a copy of the baptismal certificate to the SRRE office (unless we already have one on file.)
  If you don't remember the correct date, please write "Can't Remember."
  If you answered NO, please write: "Tentative Baptismal Date _Mo_/_Day_/_Yr_" and write N/A in the remaining church fields.
  
  Date of Baptism - Month/Day/Year (required even if baptized at St. Raphael) Please enter valid data.
  
  Baptismal Church REQUIRED Please fill out this field. Please enter valid data.
  
  Street Address REQUIRED Please fill out this field. Please enter valid data.
  
  City and State (or foreign country) REQUIRED Please fill out this field. Please enter valid data.
  
  ZIP Code Please enter valid data.
  
  Has the child already received Communion? REQUIRED Please fill out this field.
  
  Has the child already received Confirmation? REQUIRED Please fill out this field.
  
  Grade in School September 2024 REQUIRED Please fill out this field.
  
  School attending in September 2024 REQUIRED Please fill out this field. Please enter valid data.
  
  Special Circumstances. In the field below, please let us know if there are any special circumstances that could affect your child learning and participation in our classes and that we should know of (for ex.: Allergies, learning and other disabilities, marital or custody issues, etc.) This information is kept strictly confidential.
  
  Special Circumstances
  
  Child 5
  
  Child First Name (no nicknames please) REQUIRED Please fill out this field. Please enter valid data.
  
  Child Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Child Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Child Birth Date REQUIRED Please fill out this field. Please enter a date.
  
  Place of Birth (City & State) REQUIRED Please fill out this field. Please enter valid data.
  
  Child Gender REQUIRED Please fill out this field.
  
  Preferred Day and Time for Class (select only one) REQUIRED Sundays, 7:05 - 8:20 p.m. – Grades 2 - 8 + Youth Group Mondays, 4:30 - 5:45  p.m. - Grades K - 8 Mondays, 7:00 - 8:15 p.m. – Grades 1 - 12 Family Catechesis, six Sundays at 4:30, Grades K - 8 Please fill out this field.
  
  Please note: The schedule of in-person classes may change, depending on the availability of volunteer catechists for the various grade levels.
  
  Has the child been baptized? REQUIRED Please fill out this field.
  
  If you answered YES, please fill out the fields below and bring a copy of the baptismal certificate to the SRRE office (unless we already have one on file.)
  If you don't remember the correct date, please write "Can't Remember."
  If you answered NO, please write: "Tentative Baptismal Date _Mo_/_Day_/_Yr_" and write N/A in the remaining church fields.
  
  Date of Baptism - Month/Day/Year (required even if baptized at St. Raphael) Please enter valid data.
  
  Baptismal Church REQUIRED Please fill out this field. Please enter valid data.
  
  Street Address REQUIRED Please fill out this field. Please enter valid data.
  
  City and State (or foreign country) REQUIRED Please fill out this field. Please enter valid data.
  
  ZIP Code Please enter valid data.
  
  Has the child already received Communion? REQUIRED Please fill out this field.
  
  Has the child already received Confirmation? REQUIRED Please fill out this field.
  
  Grade in School September 2024 REQUIRED Please fill out this field.
  
  School attending in September 2024 REQUIRED Please fill out this field. Please enter valid data.
  
  Special Circumstances. In the field below, please let us know if there are any special circumstances that could affect your child learning and participation in our classes and that we should know of (for ex.: Allergies, learning and other disabilities, marital or custody issues, etc.) This information is kept strictly confidential.
  
  Special Circumstances
  
  Child 2
  
  Child First Name (no nicknames please) REQUIRED Please fill out this field. Please enter valid data.
  
  Child Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Child Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Child Birth Date REQUIRED Please fill out this field. Please enter a date.
  
  Place of Birth (City & State) REQUIRED Please fill out this field. Please enter valid data.
  
  Child Gender REQUIRED Please fill out this field.
  
  Preferred Day and Time for Class (select only one) REQUIRED Sundays, 7:05 - 8:20 p.m. – Grades 2 - 8 + Youth Group Mondays, 4:30 - 5:45  p.m. - Grades K - 8 Mondays, 7:00 - 8:15 p.m. – Grades 1 - 12 Family Catechesis, six Sundays at 4:30, Grades K - 8 Please fill out this field.
  
  Please note: The schedule of in-person classes may change, depending on the availability of volunteer catechists for the various grade levels.
  
  Has the child been baptized? REQUIRED Please fill out this field.
  
  If you answered YES, please fill out the fields below and bring a copy of the baptismal certificate to the SRRE office (unless we already have one on file.)
  If you don't remember the correct date, please write "Can't Remember."
  If you answered NO, please write: "Tentative Baptismal Date _Mo_/_Day_/_Yr_" and write N/A in the remaining church fields.
  
  Date of Baptism - Month/Day/Year (required even if baptized at St. Raphael) Please enter valid data.
  
  Baptismal Church REQUIRED Please fill out this field. Please enter valid data.
  
  Street Address REQUIRED Please fill out this field. Please enter valid data.
  
  City and State (or foreign country) REQUIRED Please fill out this field. Please enter valid data.
  
  ZIP Code Please enter valid data.
  
  Has the child already received Communion? REQUIRED Please fill out this field.
  
  Has the child already received Confirmation? REQUIRED Please fill out this field.
  
  Grade in School September 2024 REQUIRED Please fill out this field.
  
  School attending in September 2024 REQUIRED Please fill out this field. Please enter valid data.
  
  Special Circumstances. In the field below, please let us know if there are any special circumstances that could affect your child learning and participation in our classes and that we should know of (for ex.: Allergies, learning and other disabilities, marital or custody issues, etc.) This information is kept strictly confidential.
  
  Special Circumstances
  
  Child 3
  
  Child First Name (no nicknames please) REQUIRED Please fill out this field. Please enter valid data.
  
  Child Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Child Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Child Birth Date REQUIRED Please fill out this field. Please enter a date.
  
  Place of Birth (City & State) REQUIRED Please fill out this field. Please enter valid data.
  
  Child Gender REQUIRED Please fill out this field.
  
  Preferred Day and Time for Class (select only one) REQUIRED Sundays, 7:05 - 8:20 p.m. – Grades 2 - 8 + Youth Group Mondays, 4:30 - 5:45  p.m. - Grades K - 8 Mondays, 7:00 - 8:15 p.m. – Grades 1 - 12 Family Catechesis, six Sundays at 4:30, Grades K - 8 Please fill out this field.
  
  Please note: The schedule of in-person classes may change, depending on the availability of volunteer catechists for the various grade levels.
  
  Has the child been baptized? REQUIRED Please fill out this field.
  
  If you answered YES, please fill out the fields below and bring a copy of the baptismal certificate to the SRRE office (unless we already have one on file.)
  If you don't remember the correct date, please write "Can't Remember."
  If you answered NO, please write: "Tentative Baptismal Date _Mo_/_Day_/_Yr_" and write N/A in the remaining church fields.
  
  Date of Baptism - Month/Day/Year (required even if baptized at St. Raphael) Please enter valid data.
  
  Baptismal Church REQUIRED Please fill out this field. Please enter valid data.
  
  Street Address REQUIRED Please fill out this field. Please enter valid data.
  
  City and State (or foreign country) REQUIRED Please fill out this field. Please enter valid data.
  
  ZIP Code Please enter valid data.
  
  Has the child already received Communion? REQUIRED Please fill out this field.
  
  Has the child already received Confirmation? REQUIRED Please fill out this field.
  
  Grade in School September 2024 REQUIRED Please fill out this field.
  
  School attending in September 2024 REQUIRED Please fill out this field. Please enter valid data.
  
  Special Circumstances. In the field below, please let us know if there are any special circumstances that could affect your child learning and participation in our classes and that we should know of (for ex.: Allergies, learning and other disabilities, marital or custody issues, etc.) This information is kept strictly confidential.
  
  Special Circumstances
- Family's Preferred Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Street Address (where the children live) 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.
- Mother's First and Last Name REQUIRED Please fill out this field. Please enter valid data.
- Mother's Maiden Name REQUIRED Please fill out this field. Please enter valid data.
- Mother's Cell Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Mother's Email REQUIRED Please fill out this field. Please enter an email address.
- Mother's Religion REQUIRED Please fill out this field. Please enter valid data.
- Father's First and Last Name REQUIRED Please fill out this field. Please enter valid data.
- Father's Cell Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Father's Email REQUIRED Please fill out this field. Please enter an email address.
- Father's Religion REQUIRED Please fill out this field. Please enter valid data.
- Family's Parish Envelope Number Please enter valid data.
- Family's preferred language for communication with the office REQUIRED Please fill out this field. Please enter valid data.
- Emergency Contact (other than a parent)
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Emergency Contact Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Relationship to the child / children REQUIRED Please fill out this field. Please enter valid data.
- Tuition and Fees Statement: I understand that to enroll children in Religious Education the parish requires payment of annual tuition and sacramental fee (the latter only for children receiving Sacraments in Spring 2025). I commit to pay the appropriate amount either electronically, by personal check, or with cash (please make appointment to pay in cash) within 30 days.
  
  Tuition:
  
  $155 for 1 child
  
  $230 for 2 children in the same family
  
  $280 for 3 or more children in the same family
  
  Sacramental Fees:
  
  $75 - First Eucharist in Spring 2025
  
  $75 - Confirmation in Spring 2025
  
  Families who are struggling financially should contact DRE Mary Beaudoin to discuss available options (payment plan, scholarship, discount, exemption, etc.)
  mbeaudoin@straphaels.org
  I Understand and Agree Please select this field.
Submit

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Links to E-Payment for Religious Education
- Click Here to Pay Tuition and/or Sacramental Fee (Amount is indicated in the payment form)
Payments by Personal Check

Please make check payable to St. Raphael Religious Education. Mail to St. Raphael Religious Education, Attn: Karen Watson, 1513 Dunster Road, Rockville MD 20854 or bring to our SRRE Office.
Please do not send cash by mail. For cash payments, please make an appointment to meet a staff member in the office. Thank you.

St. Raphael
Catholic Church

Rockville, MD

2024-2025 SRRE Registration

Religious Education Registration Form

Links to E-Payment for Religious Education

Payments by Personal Check