2025-2026 PSR Registration - Holy Redeemer Catholic Parish

GENERAL INFORMATION

Family Surname(s) (Last Name) *

How many children are you registering for 2025-2026 PSR? *

What parish are you registered in? * What parish are you registered in?

Student(s) live(s) with? *

Address *

Address

City

State/Province

Zip/Postal

STUDENT INFORMATION

FIRST CHILD

The child you list as First Child will be considered "Oldest/Only" in our database and, when given, will be the child to receive information to be brought home.

Legal First Name *

Legal Last Name *

Nickname (if applicable)

Child's Birth Date *

Format 01/01/2001

Gender *

School Attended *

Please list Elementary and Middle Schools

PSR Grade Level for 2025-2026

Please note, 1st grade level is mandatory prior to 2nd as is 7th grade level is mandatory prior to 8. Transfers must verify attendance from another program.

What would you like us to know about your child to help PSR staff in meeting your child's medical, emotional, spiritual & learning needs. *

(e.g. Kathleen is on medication for...has an IEP...has a serious allergy to...experiences difficulty in...) Information will be kept confidential.

SECOND CHILD

The child you list as First Child will be considered "Oldest/Only" in our database and, when given, will be the child to receive information to be brought home.

Legal First Name *

Legal Last Name *

Nickname (if applicable)

Child's Birth Date *

Format 01/01/2001

Gender *

School Attended *

Please list Elementary and Middle Schools

PSR Grade Level for 2025-2026

Please note, 1st grade level is mandatory prior to 2nd as is 7th grade level is mandatory prior to 8. Transfers must verify attendance from another program.

What would you like us to know about your child to help PSR staff in meeting your child's medical, emotional, spiritual & learning needs. *

(e.g. Kathleen is on medication for...has an IEP...has a serious allergy to...experiences difficulty in...) Information will be kept confidential.

THIRD CHILD

The child you list as First Child will be considered "Oldest/Only" in our database and, when given, will be the child to receive information to be brought home.

Legal First Name *

Legal Last Name *

Nickname (if applicable)

Child's Birth Date *

Format 01/01/2001

Gender *

School Attended *

Please list Elementary and Middle Schools

PSR Grade Level for 2025-2026

Please note, 1st grade level is mandatory prior to 2nd as is 7th grade level is mandatory prior to 8. Transfers must verify attendance from another program.

What would you like us to know about your child to help PSR staff in meeting your child's medical, emotional, spiritual & learning needs. *

(e.g. Kathleen is on medication for...has an IEP...has a serious allergy to...experiences difficulty in...) Information will be kept confidential.

FOURTH CHILD

The child you list as First Child will be considered "Oldest/Only" in our database and, when given, will be the child to receive information to be brought home.

Legal First Name

Legal Last Name

Nickname (if applicable)

Child's Birth Date

Format 01/01/2001

Gender

School Attended

Please list Elementary and Middle Schools

PSR Grade Level for 2025-2026

Please note, 1st grade level is mandatory prior to 2nd as is 7th grade level is mandatory prior to 8. Transfers must verify attendance from another program.

What would you like us to know about your child to help PSR staff in meeting your child's medical, emotional, spiritual & learning needs.

(e.g. Kathleen is on medication for...has an IEP...has a serious allergy to...experiences difficulty in...) Information will be kept confidential.

FIFTH CHILD

The child you list as First Child will be considered "Oldest/Only" in our database and, when given, will be the child to receive information to be brought home.

Legal First Name

Legal Last Name

Nickname (if applicable)

Child's Birth Date

Format 01/01/2001

Gender

School Attended

Please list Elementary and Middle Schools

PSR Grade Level for 2025-2026

Please note, 1st grade level is mandatory prior to 2nd as is 7th grade level is mandatory prior to 8. Transfers must verify attendance from another program.

What would you like us to know about your child to help PSR staff in meeting your child's medical, emotional, spiritual & learning needs.

(e.g. Kathleen is on medication for...has an IEP...has a serious allergy to...experiences difficulty in...) Information will be kept confidential.

SIXTH CHILD

The child you list as First Child will be considered "Oldest/Only" in our database and, when given, will be the child to receive information to be brought home.

Legal First Name

Legal Last Name

Nickname (if applicable)

Child's Birth Date

Format 01/01/2001

Gender

School Attended

Please list Elementary and Middle Schools

PSR Grade Level for 2025-2026

Please note, 1st grade level is mandatory prior to 2nd as is 7th grade level is mandatory prior to 8. Transfers must verify attendance from another program.

What would you like us to know about your child to help PSR staff in meeting your child's medical, emotional, spiritual & learning needs.

(e.g. Kathleen is on medication for...has an IEP...has a serious allergy to...experiences difficulty in...) Information will be kept confidential.

PARENT/GUARDIAN INFORMATION

The following information is needed for our database and the students' permanent and Sacramental records.

Mother's First Name

Last Name

Maiden Name if applicable

Living/Deceased?

Religion of Mother Religion of Mother

Marital Status of Mother

Father's First Name

Last Name

Living/Deceased?

Religion of Father Religion of Father

Marital Status of Father

Guardian First Name

Guardian Last Name

Religion of Guardian Religion of Guardian

CONTACT INFORMATION

Please submit the parents'/guardian's contact information.

Primary Phone Number *

Whose phone # is this? * Whose phone # is this?

Secondary Phone Number

Whose phone # is this? Whose phone # is this?

Primary Email *

Secondary Email

Emergency Contact 1 (other than parent/guardian listed above) *

First and Last Name, Relationship to Student(s)

Emergency Contact 1 Phone Number *

Emergency Contact 2 (other than parent/guardian listed above) *

First and Last Name, Relationship to Student(s)

Emergency Contact 2 Phone Number *

DISMISSAL

Dismissal will be at 7:30pm. Please indicate your dismissal preference. The parking lot is "closed" while children are walking. Cars may NOT move until all children are safely in their car. Those being picked up in the parking lot will be escorted through the exterior gym doors. Dismissal parking is NOT on Joy or Lockwood. Those walking home will exit at the front doors of the school.

Dismissal Preference *

Additional people allowed to pick up my children other than parents/guardians and emergency contact. *

MEDIA AUTHORIZATION

For marketing and publicity purposes, there may be times when the school/parish wishes to use your and/or your child(ren)’s image, name, recording, or academic work in various media for marketing and/or publicity purposes. Our purpose for asking is to mainly use in the bulletin and on the website. As a parent, you may grant or deny authorization.

I grant permission to use my or my child(ren)’s image, name, recording, or academic work in communications that include, but are not limited to, the parish bulletin, school newsletter, parish/school website and social media. *

PARENT PARTICIPATION

Parents are the life breath to successful faith formation! We have a number of ways for you to be involved.

Catechist: acts as the faith educator/teacher in the classroom and receives a stipend. Arrive each week by 6:15.

Classroom Aid: makes a weekly commitment and assists the Catechist in the classroom. Tuition is waived. Arrive each week by 6:15.

Safety Team: helps with floor monitoring and dismissal every few weeks. Arrive at 6:15.

Room Parent: periodically helps with classroom necessities.

Arrival and Dismissal: periodically help with ensuring students get into the building and that dismissal runs smoothly. Arrive at 6:15 to help with arrival. Arrive at 7:15 to help with Dismissal.

All volunteer adults must go through Protecting God's Children, have a background check and sign a Code of Ethical Conduct.

Please indicate your preference to help in one of the following areas: *

REGISTRATION FEE

Pay now in full or a $50 deposit for the 2025-2026 school year.
# of children Parishioner Rate
1 child $250
2 children $465
3 or more $670
You may work out a payment plan with Carol Herber, cherber@holyr.org.

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