PREP Registration Form

2021-2022 PREP

St. Bernadette PREP will be in person with the possibilty of COVID-19 saftey restricitions. St. Bernadette PREP will follow the most updated saftey guidance along with whatever saftey guidelines St. Bernadette School has in place. These guidelines are always subject to change. If your famiy does not feel comfortable with the in person model, please contact Marykate Murphy, DRE for a home based plan with support from our PREP program.

We ackowldedge and agree to the above statement. Please select this field.

2021-2022 PREP GRADE ACKNOWLEDGEMENT REQUIRED Our family participated in the 2020-2021 Virtual PREP Program and our child/ren will continue to the next grade level. Our family participated in the Summer 2021 Virtual PREP Program and our child/ren will continue to the next grade level. Our family did not participate in the 2020-2021 Virtual PREP Program or the Summer 2021 Virtual PREP Program. Our child/ren will be in the grade they missed. Our program is cumulative and each grade builds on the next. Please fill out this field.

Number of Students being registered REQUIRED Please fill out this field.
Student 1
- Student Name REQUIRED
  Please provice the student's First and Last Name
  Please fill out this field. Please enter valid data.
- Birthdate REQUIRED
  ex: 02/05/2010
  Please fill out this field. Please enter a date.
- PREP Grade Level Please enter valid data.
- Public School your child attends Please enter valid data.
- School Grade Please enter valid data.
- PLEASE CHOOSE ONE: This student is a RETURNING STUDENT to the PREP Program and Baptismal Information is on file This student is a NEW STUDENT to the PREP program. Please provide the EXACT BAPTISMAL DATE. IF your child was not baptized at St. Bernadette, please provide a copy of the Baptismal Certificate.
- PLEASE PROVIDE EXACT DATE AND PARISH OF BAPTISM for NEW STUDENTS ONLY Please enter valid data.
- Check all other Sacraments this Student has received Penance First Communion Confirmation
- IF STUDENT IS ENTERING OUR PREP PROGRAM AS A NEW STUDENT, ABOVE GRADE 1 - PLEASE PROVIDE WHICH PARISH RELIGIOUS EDUCATION PROGRAM WAS PREVIOUSLY ATTENDED AND WHICH GRADE LEVEL WAS COMPLETED.
Student 2
- Student Name REQUIRED
  Please provice the student's First and Last Name
  Please fill out this field. Please enter valid data.
- Birthdate REQUIRED
  ex: 02/05/2010
  Please fill out this field. Please enter a date.
- PREP Grade Level Please enter valid data.
- Public School your child attends Please enter valid data.
- School Grade Please enter valid data.
- PLEASE CHOOSE ONE: This student is a RETURNING STUDENT to the PREP Program and Baptismal Information is on file This student is a NEW STUDENT to the PREP program. Please provide the EXACT BAPTISMAL DATE. IF your child was not baptized at St. Bernadette, please provide a copy of the Baptismal Certificate.
- PLEASE PROVIDE EXACT DATE AND PARISH OF BAPTISM for NEW STUDENTS ONLY Please enter valid data.
- Check all other Sacraments this Student has received Penance First Communion Confirmation
- IF STUDENT IS ENTERING OUR PREP PROGRAM AS A NEW STUDENT, ABOVE GRADE 1 - PLEASE PROVIDE WHICH PARISH RELIGIOUS EDUCATION PROGRAM WAS PREVIOUSLY ATTENDED AND WHICH GRADE LEVEL WAS COMPLETED.
Student 3
- Student Name REQUIRED
  Please provice the student's First and Last Name
  Please fill out this field. Please enter valid data.
- Birthdate REQUIRED
  ex: 02/05/2010
  Please fill out this field. Please enter a date.
- PREP Grade Level Please enter valid data.
- Public School your child attends Please enter valid data.
- School Grade Please enter valid data.
- PLEASE CHOOSE ONE: This student is a RETURNING STUDENT to the PREP Program and Baptismal Information is on file This student is a NEW STUDENT to the PREP program. Please provide the EXACT BAPTISMAL DATE. IF your child was not baptized at St. Bernadette, please provide a copy of the Baptismal Certificate.
- PLEASE PROVIDE EXACT DATE AND PARISH OF BAPTISM for NEW STUDENTS ONLY Please enter valid data.
- Check all other Sacraments this Student has received Penance First Communion Confirmation
- IF STUDENT IS ENTERING OUR PREP PROGRAM AS A NEW STUDENT, ABOVE GRADE 1 - PLEASE PROVIDE WHICH PARISH RELIGIOUS EDUCATION PROGRAM WAS PREVIOUSLY ATTENDED AND WHICH GRADE LEVEL WAS COMPLETED.
Student 4
- Student Name REQUIRED
  Please provice the student's First and Last Name
  Please fill out this field. Please enter valid data.
- Birthdate REQUIRED
  ex: 02/05/2010
  Please fill out this field. Please enter a date.
- PREP Grade Level Please enter valid data.
- Public School your child attends Please enter valid data.
- School Grade Please enter valid data.
- PLEASE CHOOSE ONE: This student is a RETURNING STUDENT to the PREP Program and Baptismal Information is on file This student is a NEW STUDENT to the PREP program. Please provide the EXACT BAPTISMAL DATE. IF your child was not baptized at St. Bernadette, please provide a copy of the Baptismal Certificate.
- PLEASE PROVIDE EXACT DATE AND PARISH OF BAPTISM for NEW STUDENTS ONLY Please enter valid data.
- Check all other Sacraments this Student has received Penance First Communion Confirmation
- IF STUDENT IS ENTERING OUR PREP PROGRAM AS A NEW STUDENT, ABOVE GRADE 1 - PLEASE PROVIDE WHICH PARISH RELIGIOUS EDUCATION PROGRAM WAS PREVIOUSLY ATTENDED AND WHICH GRADE LEVEL WAS COMPLETED.
Student 5
- Student Name REQUIRED
  Please provice the student's First and Last Name
  Please fill out this field. Please enter valid data.
- Birthdate REQUIRED
  ex: 02/05/2010
  Please fill out this field. Please enter a date.
- PREP Grade Level Please enter valid data.
- Public School your child attends Please enter valid data.
- School Grade Please enter valid data.
- PLEASE CHOOSE ONE: This student is a RETURNING STUDENT to the PREP Program and Baptismal Information is on file This student is a NEW STUDENT to the PREP program. Please provide the EXACT BAPTISMAL DATE. IF your child was not baptized at St. Bernadette, please provide a copy of the Baptismal Certificate.
- PLEASE PROVIDE EXACT DATE AND PARISH OF BAPTISM for NEW STUDENTS ONLY Please enter valid data.
- Check all other Sacraments this Student has received Penance First Communion Confirmation
- IF STUDENT IS ENTERING OUR PREP PROGRAM AS A NEW STUDENT, ABOVE GRADE 1 - PLEASE PROVIDE WHICH PARISH RELIGIOUS EDUCATION PROGRAM WAS PREVIOUSLY ATTENDED AND WHICH GRADE LEVEL WAS COMPLETED.

FAMILY INFORMATION

Family Name REQUIRED Please fill out this field. Please enter valid data.
Primary Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
Primary Family Email REQUIRED Please fill out this field. Please enter an email address.
We are REGISTERED MEMBERS of St. Bernadette of Lourdes Parish REQUIRED Yes No - I understand that our family will have to register at St. Bernadette Parish or get a letter of permission my our Parish to attend PREP at St. Bernadette. Please fill out this field.
Please choose one REQUIRED We are a RETURNING family and our "Family Information" HAS NOT changed from last year. Please skip the rest of this section and move to the Medical and Educational Information We are a RETURNING FAMILY and our "Family Information" HAS changed. Please update the Family Information Section. We are a NEW family to the PREP Program. Please complete the "Family Information Section" Please fill out this field.
Address Please enter valid data.
City Please enter valid data.

State

Zip Please enter a zip code.
Father's Name Please enter valid data.
Cell Phone Maximum 20 characters Please enter a phone number.
Email Please enter an email address.
Mother's Name Please enter valid data.
Cell Phone Maximum 20 characters Please enter a phone number.
Email Please enter an email address.
Custody: Are there any legal/custody issues? (If yes, please provide a copy of the most current court order.) Yes No
*Name of person responsible for Religious Education if NOT a Parent/Guardian.

MEDICAL AND EDUCATIONAL INFORMATION

Emergency Contact REQUIRED Please fill out this field.
Cell Phone Maximum 20 characters Please enter a phone number.
Home Phone Maximum 20 characters Please enter a phone number.
Relationship to Family Please enter valid data.
Are all students in your family up to date on their immunizations? REQUIRED YES NO Please fill out this field.
If all students are not up to date on their immunizations, do they have the proper exception forms? REQUIRED N/A YES NO Please fill out this field.
** Immunization: Even if your child is exempt from immunizations, he/she may be excluded from in-person PREP during an outbreak of the vaccine preventable disease.
Permission is given for my child/ren, in my absence, to recieve emergency medical care for injuries or situations that may occur during Religious Education Program hours and/or activites at St. Berndaette Parish YES NO
Medical/Learning Data

Our family agrees to read and abide by the St. Bernadette Parish Religious Education Program Handbook. Agree

The Handbook can be found HERE!

Permission is given for my child's picture and/or name to appear on the St. Bernadette website, bulletin boards, social media, and newspaper articles in relation to events that happen in the parish. YES NO

Our program runs on the generosity of our volunteers and God always provides the right people
~ GOD IS GOOD ALL THE TIME, ALL THE TIME GOD IS GOOD ~
The more volunteers we have, the better our program will become. Please contact Marykate Murphy if you are interested in volunteer oppurtunities.

There is a fee required for all students who attend Religious Education Classes at St. Bernadette’s.

2021-2022 PREP Tuition
Please note ~ our fees have stayed the same for the last 7 years.
To respect families still trying to decide about in person PREP, there will be no late registration fees this year. Please plan to register by August 31, 2021

1 Child - $175 (5.84 a week)
2 Children - $320 ($10.67 a week)
3 or more Children - $370 ($12.34 a week)
A deposit of $50 per family is required at the time of registration, which will be applied to the final fees.
All PREP Tuition must be paid in full by
December 31, 2021

All PREP families are asked to fulfill their obligation to attend Sunday Mass.
We kindly ask all families to contribute at least $20.00 to the weekly Sunday Collections .

We agree to pay the required PREP Tuition, in full, as indicated (Check all that apply): REQUIRED

Check all that apply

One payment Weekly payment plan, due in full by December 31, 2021 Monthly payment plan, due in full by December 31, 2021 Scrip Payments Please fill out this field.

Payment Plan:

By submitting this form, I/We attest that all the information provided is correct. I/We understand that this information will be used by the Religious Education Office and to upate the St. Bernadette Parish database. I/We agree that all PREP fees will be paid as indicated above.

I Agree Please select this field.

Date Submitted REQUIRED Please fill out this field. Please enter a date.

St. Bernadette School

Leading in Innovation Learning in Faith

PREP Registration Form

2021-2022 PREP REGISTRATION ~ PLEASE CONTACT MS. MURPHY IF YOU NEED TO REGISTER!