PREP Returning Student Registration Form 2026 - 2027 - St. John the Evangelist-St. Charles Borromeo Parish

FAMILY INFORMATION:

Family Name REQUIRED Please fill out this field. Please enter valid data.

Family Home Mailing Address REQUIRED Please fill out this field. Please enter valid data.

P. O. Box (if applicable) Please enter valid data.

Email REQUIRED Please fill out this field. Please enter an email address.

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.

Home Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Mother's name Please enter valid data.

Mother's Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Mother's Maiden Name Please enter valid data.

Mother's Religion REQUIRED Please fill out this field. Please enter valid data.

Father's Name Please enter valid data.

Father's Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Father's Religion Please enter valid data.

ENTER EACH CHILD IN YOUR FAMILY BELOW:

1. Child's Name REQUIRED Please fill out this field. Please enter valid data.

Religious Education Grade REQUIRED Please fill out this field.

Date of Birth REQUIRED Please fill out this field. Please enter a date.

School Name as of September REQUIRED Please fill out this field. Please enter valid data.

School Grade this September REQUIRED Please fill out this field.

Does this child have any new medical information we should know about? REQUIRED Yes No Please fill out this field.

If medical information needs to be updated, please complete the information at the bottom of this form.

2. Child's Name Please enter valid data.

Religious Education Grade

Date of Birth Please enter a date.

School Name as of September Please enter valid data.

School Grade this September

Does this child have any new medical information we should know about? REQUIRED Yes No Please fill out this field.

If medical information needs to be updated, please complete the information at the bottom of this form.

3. Child's Name Please enter valid data.

Religious Education Grade

Date of Birth Please enter a date.

School Name as of September Please enter valid data.

School Grade this September

Does this child have any new medical information we should know about? REQUIRED Yes No Please fill out this field.

If medical information needs to be updated, please complete the information at the bottom of this form.

NEW MEDICAL INFORMATION

Specify new medical condition Please enter valid data.

Procedure to be followed if this condition becomes an emergency.

I understand that in case of an emergency, "911" will be called and an ambulance may be called by the Director of Religious Education or his/her designate. In case of accident or illness, I request that the representative of the parish catechetical program contact me If I am unable to be reached, I hereby authorize this representative to call the physician indicated and to follow the physician's instructions. If it is impossible to contact this physician, the representative of the parish catechetical program may make whatever arrangements see necessary. I agree to assume the financial responsibility for any diagnosis, treatment and/or medication deemed necessary. To the best of my knowledge all information given is accurate and complete.

I hereby consent to, and authorize the necessary procedures that have been stated above. : Yes No

Have any of these children developed allergies? Yes No

If "Yes" please list the child's name and new allergy information.

Course of action to be followed if allergy presents an emergency condition:

What medication will be administered?: Please enter valid data.

Who will administer medication?: Please enter valid data.

Role of this person.: Please enter valid data.

Where will this medication be kept so as to be readily available?: Please enter valid data.

What other actions will be taken and by whom?:

Whenever emergency medication is administered, "911" will be called without exception.

PERMISSIONS

I give my permission for St. John the Evangelist-St. Charles Borromeo Church to photograph or videotape my child/children to be used for internal purposes. Pictures/videos will not be released to the public without specific consent.
(Selecting NO disallows any class picture of use of your child/children's image in any presentation.)

Do you give photo/video permission for your child or children? REQUIRED YES NO Please fill out this field.

I give my permission for my child/children to use the Internet for research and/or assignments. REQUIRED YES NO Please fill out this field.

I give my permission for my phone number to be given to the CRISIS PHONE PERSON for his/her class to be used in an emergency. (Checking NO may hinder our reaching you in an emergency.)

Please submit your PREP registration by clicking the link below. AFTER you submit your registration form you can click the link to submit your registration fees.
Registration will not be finalized until payment is received.

I give permission for my phone number to be given to the CRISIS PHONE PERSON. REQUIRED YES NO Please fill out this field.

PLEASE NOTE: Registrations

will not be processed without payment.

Please submit this form
before making your payment.

St. John the Evangelist (Pawling, NY)
St. Charles Borromeo (Dover Plains, NY)

PREP Returning Student Registration Form 2026 - 2027

PREP Registration
April 1st - June 30th

No registrations will be taken after June 30th.

Online Registration Form for Returning Students

FAMILY INFORMATION:

ENTER EACH CHILD IN YOUR FAMILY BELOW:

If medical information needs to be updated, please complete the information at the bottom of this form.

NEW MEDICAL INFORMATION

PERMISSIONS

PLEASE NOTE: Registrations

will not be processed without payment.

MAKE A PAYMENT

If you are paying by check or cash,
please give your payment directly to Nan Kramer

PREP Returning Student Registration Form 2026 - 2027

PREP RegistrationApril 1st - June 30th

No registrations will be taken after June 30th.

FAMILY INFORMATION:

ENTER EACH CHILD IN YOUR FAMILY BELOW:

If medical information needs to be updated, please complete the information at the bottom of this form.

NEW MEDICAL INFORMATION

PERMISSIONS

PLEASE NOTE: Registrations

will not be processed without payment.

MAKE A PAYMENT

If you are paying by check or cash,please give your payment directly to Nan Kramer

PREP Registration
April 1st - June 30th

If you are paying by check or cash,
please give your payment directly to Nan Kramer