PSR/Confirmation Registration

Please use a separate form for each child

• The maximum number of form submissions has been reached. This form is currently not available.

  • Child's grade in the fall REQUIRED Please fill out this field. Please enter valid data.
  • Child's name REQUIRED Please fill out this field. Please enter valid data.
  • Date of birth REQUIRED Please fill out this field. Please enter valid data.
  • Place of birth REQUIRED Please fill out this field. Please enter valid data.
  • Date of baptism REQUIRED Please fill out this field. Please enter valid data.
  • Church of baptism REQUIRED Please fill out this field. Please enter valid data.
  • Date of 1st Communion REQUIRED Please fill out this field. Please enter valid data.
  • Church of 1st Communion REQUIRED Please fill out this field. Please enter valid data.
  • My child is preparing for 1st Communion REQUIRED yes No Please fill out this field.
  • My child is preparing for Confirmation REQUIRED yes No Please fill out this field.
  • If your child is preparing for Confirmation, they will need a sponsor.
    
    Sponsors should be a practicing Catholics and someone your child looks up to in matters of faith. Sponsors will journey alongside your child as they prepare for this important Sacrament.
    
    Please also provide the name and phone number of the Church they attend.
  • Name of proposed Sponsor, Church they attend, Church's phone number Please enter valid data.
  • Mother's name (Please include maiden name) REQUIRED Please fill out this field. Please enter valid data.
  • Father's name REQUIRED Please fill out this field. Please enter valid data.
  • Street number and name REQUIRED Please fill out this field. Please enter valid data.
  • City REQUIRED Please fill out this field. Please enter valid data.

    State REQUIRED AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MH MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR PW RI SC SD TN TX UT VA VI VT WA WI WV WY Please fill out this field.

    Zip REQUIRED Please fill out this field. Please enter a zip code.
  • Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  • Cell Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  • Email REQUIRED Please fill out this field. Please enter an email address.
  • Emergency Contact Name and phone number REQUIRED Please fill out this field.
  • I give my permission to have candid and/or formal photos of my child taken with the understanding that these photos may be displayed on the Mater Dolorosa/St. Dominic website, local newspaper, Catholic commentator, Mater Dolorosa Facebook page, and/or in gathering areas of Mater Dolorosa/ St. Dominic.

    I Agree Please select this field.
  • Registration Fee

    If you would rather pay by check or cash, click proceed to payment, and contact Allison Dreher at 985-878-9639. Registration is free from the 4th child on.

    35.0 –  Registration Fee- 1st child

    35.0 –  Registration Fee 2nd child

    35.0 –  Registration Fee- 3rd Child

    0.0 –  Registration Fee 4th child on 

  Total:

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