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PRE Registration

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NOTICE: If you register online, you must pay online.
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Family Last Name *

What language is best for communication from our office? *

English
Other

What language?

Number of Children (to register) *

1
2
3
4

Address *

Primary Email *

Secondary Email *

Primary Phone *

City, State Zip *

Parent/Guardian Name *

Religion *

Cellphone *

Spouse? *

Yes
No

Parent/Guardian Name *

Religion *

Cellphone *

Choose a Class Time Below *

Sunday, 3-4 yr. olds: During 10:30 Mass
Sunday, 9:00AM-10:15AM: K-7th & Confirmation Prep (8th-12th)
Wednesday, 5:30PM-6:45PM: 1st-7th, Confirmation Prep (8th-12th), RCIC (3rd-8th)

First Child Name *

Nickname

Gender *

Male
Female

Birth Date *

Fall Age/Grade *

School *

Sacrament History *

None
Baptism
Reconciliation
Communion
Confirmation

Baptism Date *

Parish, City, State *

Communion Date *

Parish, City, State *

Confirmation Date *

Parish, City, State *

Did your child have religious ed last year? *

Yes
No

The Diocese requires 2 consecutive years of religious ed for sacraments.

Where? *

Desired Sacraments This Year

Baptism
Reconciliation
Communion
Confirmation

Tuition

Communion Year Fee

Confirmation Year Fee

Second Child Name *

Nickname

Gender *

Male
Female

Birth Date *

Fall Age/Grade *

School *

Sacrament History *

None
Baptism
Reconciliation
Communion
Confirmation

Baptism Date *

Parish, City, State *

1st Communion Date *

Parish, City, State *

Confirmation Date *

Parish, City, State *

Did your child have religious ed last year? *

Yes
No

The Diocese requires 2 consecutive years of religious ed for sacraments.

Where? *

Desired Sacraments This Year

Baptism
Reconciliation
Communion
Confirmation

Tuition

Communion Year Fee

Confirmation Year Fee

Third Child Name *

Nickname

Gender *

Male
Female

Birth Date *

Fall Age/Grade *

School *

Sacrament History *

None
Baptism
Reconciliation
Communion
Confirmation

Baptism Date *

Parish, City, State *

1st Communion date *

Parish, City, State *

Confirmation Date *

Parish, City, State *

Did your child have religious ed last year? *

Yes
No

The Diocese requires 2 consecutive years of religious ed for sacraments.

Where? *

Desired Sacraments This Year

Baptism
Reconciliation
Communion
Confirmation

Tuition

Communion Year Fee

Confirmation Year Fee

Fourth Child Name *

Nickname

Gender *

Male
Female

Birth Date *

Fall Age/Grade *

School *

Cellphone Kid

Sacrament History *

None
Baptism
Reconciliation
Communion
Confirmation

Baptism Date *

Parish, City, State *

1st Communion Date *

Parish, City, State *

Confirmation Date *

Parish, City, State *

Did your child have religious ed last year? *

Yes
No

The Diocese requires 2 consecutive years of religious ed for sacraments.

Where? *

Desired Sacraments This Year

Baptism
Reconciliation
Communion
Confirmation

Tuition

Communion Year Fee

Confirmation Year Fee

NEW students must have sacrament certificates. If you're on your phone, take pictures and use the buttons below. If you aren't, send them later to: [email protected]

certificates

Got it.
I need help.

upload 1

upload 2

upload 3

Emergency Contact (other than parent) *

Relationship *

Phone Number *

Cell Number

Any student have food/drug allergies? *

Yes
No

Name, allergy *

Anyone carry an Epi-Pen? *

Yes
No

Student Name *

Any student require medication during class? *

Yes
No

Student, Meds *

Any other health issues we should know about? *

Yes
No

Students, Conditions *

Any learning issues we should know about? *

Yes
No

Students, Differences *

RELEASE
I authorize the Incarnation Staff to summon emergency medical treatment in the event my child (children) becomes seriously ill or injured, and I further release Incarnation Staff and the Diocese of Memphis from any and all liability and waive any claims against them in regard to any accident or injury by participation in any activities of an Incarnation program.

By checking this box and supplying today's date, I agree to the terms above.

Single Checkbox Field *

By checking this box and supplying today's date, I agree to the terms above.

Today's Date *

I am a catechist for 2023-2024 (1/2 price tuition) *

Yes
No

Tuition: {calc:tuition_}

Discount Factor

Sacraments: {calc:sacraments}

Discount: {calc:catechist_discount}

Total: {calc:total}

Please proceed to payment

Payment

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After submission, you will see a link to our online payment window.
Please forward a copy of your receipt to [email protected].

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PRE Registration

NOTICE: If you register online, you must pay online.Thank you! <

NOTICE: If you register online, you must pay online.
Thank you!
<