St. Madeline Parish

Rectory - 110 Park Street, Ridley Park
Church - 400 Morton Avenue, Ridley Park

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Existing Family Registration

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Existing Family Registration
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- Family Name REQUIRED Please fill out this field. Please enter valid data.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Please list names of children and the PREP Level they will be in this coming September REQUIRED Please fill out this field.
- If you are registering new child into the program please provide the following (Full Name, Date of Birth, Sex, Race, ethnicity, School attending and grade) as well as any medical/social/educational issues we may need to be aware of.
- If any of your contact information has changed? Please update that information now.
- I give permission for my child(ren) to be photographed, to have the photos displayed in church and/or on social media, and to be included in live-streamed masses or events. REQUIRED Yes No Please fill out this field.
- I give permission that, in my absence, my child(ren) may receive emergency medical care for injuries and all situations that should occur while participating in St. Madeline PREP classes and activities. Yes No
- Registration Fee REQUIRED
  130.0 – One Child
  180.0 – Family Please fill out this field.
Total:

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