PSR Registration

PSR - Registration Form

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My child is registering for:

Information Mother's person:

Student Information (One form per student)

Student Name

First

Middle

Last

Address:

Address Line 1

City

State

Zip Code

Birthdate:

Has this child been baptized?

Yes
No

Has this child made First Holy Communion?

Yes
No

Place of Birth (City and State)

Place of Baptism (Name of Church, City, State)

Has this child received First Reconcilliation?

Yes
No

Parental Information

Father's Name:

First

Middle

Last

Father's Religion:

Father's Phone:

Are text messages OK?

Yes
No

Father's Email

Mother's Name:

First

Middle

Last

Mother's Religion:

Mother's Phone:

Are text messages OK?

Yes
No

Mother's Email

Parents/Guardians:

We will be taking photographs and/or digital images of children randomly throughout the school year for publication on our website or other media purposes (i.e.- newsletter, bulletin, etc.) Your permission is needed in case your child's photograph is used.

I hereby give my consent to St. WIlliam Parish for photographs of my child to be used for website or media purposes. I further state that I have the right to grant this permission, as I am the child's parent or legal guardian.

I HAVE READ AND UNDERSTAND THE ABOVE PHOTO RELEASE. I AFFIRM I AM PARENT/GUARDIAN OF:

Child's Name:

Parent or Legal Guardian Name:

St. William Church

5411 Mahoning Ave. NW
Warren, Ohio 44483
330/847-8677

Parish Office Hours:

Monday – Thursday ~ 9:00 a.m. – 3:00 p.m.

Friday ~ Closed

Mass Schedule:

Saturday: 4:00 p.m.

Sunday: 10:30 a.m.

Daily Mass: Tuesday & Thursday ~ 8:30 a.m.

Holy Days: Check bulletin for days and times