PSR Registration

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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 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
Our payment processing company charges the church 3% per transaction. If you would like to pay this fee so the entire $20 stays with the church, it is $0.60 per child. Registration is free after the 3rd child.

30.0 – Registration Fee- 1st child
0.9 – 3% Processing fee (optional)
30.0 – Registration Fee 2nd child
0.9 – 3% processing fee (optional)
25.0 – Registration Fee- 3rd Child
0.75 – 3% processing fee (optional)

Total:

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