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Revised Handbook

PSR Rev. Handbook

PSR Registration Form

PSR Registration Form

St. Jude Parish School of Religion Registration Form
for the ______________ School Year     (Complete both sides of the Form)
Student Information (Complete all information)
Student's Baptismal Name: ________________________________________________________________
                                                                          Last                                                                        First                                                       Middle 
Nickname: ___________________________   Birth Date ____/____/____    Circle one:   Male      Female
Student's Address: _________________________________________________________________________
                                    Street Address                                                                                     
                                                                 City                                                                                                                  State                                                Zip Code
Student lives with (Circle one): Both Parents  Mother  Father  Other Guardian
Parish where family is registered: _____________________________________________________________________
                                                                                    Name of Church
Name of Public School now attending: ________________________________________________ Grade Level:  _____                        Registering for PSR Grade: _____ Circle all PSR Grades your child has completed:  1     2      3      4      5      6      7      8
Please list any information regarding your child that a teacher should know (e.g. medical alert, special needs, etc.)
New students to the PSR program
A copy of the Baptismal Certificate is required for all NEW students registering for the PSR program.
Please list the dates and churches where the student celebrated the following sacraments (complete all that apply). 

Baptism: _______________________________________________________________________ Date ____/____/____
                                                        Name of Church
                                                          City                                                                                                                           State                                          Zip code
First Communion: ________________________________________________________________ Date____/____/____
                                                        Name of Church
Confirmation: ____________________________________________________________________Date____/____/____
                                                        Name of Church
Contact Information (Complete all that apply.)
Mother’s contact information _________________________________________________________________________
   Mother’s Name                           Home Phone
Work Phone    Cell Phone    E-mail address
Address (if different than student’s): _________________________________________ Stepfather _________________
Father’s contact information __________________________________________________________________________
     Father’s Name                           Home Phone
______________________________________________________________________________________________________________________________________  Work Phone    Cell Phone    E-mail address

Address (if different than student’s): __________________________________________ Stepmother _______________
Guardian’s contact information (if applicable): ___________________________________________________________
        Guardian’s Name                         Home Phone
______________________________________________________________________________________________________________________________________  Work Phone  Cell Phone     E-mail address

Parents Pledge
As parents/guardians, we recognize and accept our role as the primary religious educators of our children.  We pledge to support the PSR program and its catechists regarding attendance, participation, discipline, and homework assignments. We will do our part to encourage our child’s spiritual growth by regularly attending mass and receiving the sacraments.

Signature: (Required) _______________________________________________________

Fees: $70 for each child before May 31st and  $90 for each child after May 31st.  Make checks payable to St. Jude Parish.  Return all forms and payment to the Parish office by August 15th.
No child will be denied a religious education due to a lack of payment.
If you need tuition assistance, please contact the parish office.
Fee Discounts and waivers are available for parents who volunteer in the PSR program.
____I am interested in volunteering as a Catechist, a Classroom Assistant, or Hall Monitor during PSR class times.  Name: ____________________________________ Phone # ______________________________
The following release form will enable my child to participate in all scheduled PSR and sacramental preparation activities as identified in the PSR Handbook and as amended in the PSR newsletter.

1.  I, the lawful parent or guardian of (name of student) (the "child"), give permission for my child to participate in the activity described above and release from all liability and indemnify the Archbishop of Cincinnati ("the Archbishop"), both individually and as trustee for the Archdiocese of Cincinnati and all parishes within the Archdiocese, and their officers, agents, representatives, volunteers, and employees from any and all liability, claims, judgments, cost or expenses, including attorney fees, arising out of any injury or illness incurred by my child while participating in or traveling to or from the activity.

2. I agree to instruct my child to cooperate with the Archbishop or his agents in charge of the activity.

3a. I appoint the Archbishop or his agents who are acting as leaders of the activity as my attorney in fact to act for me in my name and my behalf, in any way that I would act if I were personally present, with respect to the following matters if any injury, illness or medical emergency occurs during the activity or related travel:

(i) To give any and all consents and authorizations to any physicians, dentist, hospital or other persons or institutions pertaining to any emergency medications, medical or dental treatments, diagnostic or surgical procedures or any other emergency actions as our attorney shall deem necessary or appropriate for the best interest of the child.

(ii) I understand that the agents of the Archbishop will make a reasonable attempt to contact me as soon as possible in the event of a medical emergency involving my child.

3b. This power of attorney shall lapse automatically upon completion of the activity and related travel.

4.  I agree that the Archbishop or his agents may use my child's portrait or photograph for promotional purposes, website and office functions.

I have carefully read this statement, and my signature acknowledges that I fully understand the content and meaning.
**Parent Signature: ___________________________________________________  Date____/____/____ 
**Printed Name: _____________________________________________________
Emergency Medical Preferences (**Required information)
**Doctor's Name: ______________________________________________________   Phone: _______________________

**Dentist's Name: ______________________________________________________  Phone: ________________________
**Medical Specialist: _____________________________________________________  Phone: _______________________
**Local Hospital: _______________________________________________________  Phone: _______________________ 
                                                         Children's Hospital Emergency Room # is 636-4293
**Facts concerning the child's medical history including chronic conditions, allergies, medications being taken and any physical impairments to which a physician should be alerted: _________________________________________________________________________________
**Emergency Contact if mother, father, or guardian cannot be reached: ______________________________________________________
         Last Name    First Name __________________________________________________________________________________________________
                                           Relationship to student       Evening phone number

**All required information must be completed on the Registration Form !


PSR Schedule 2015-2016

`PSR Schedule 2015-16     

  7  Labor Day – No PSR
           14 PSR Opening mass in church – students   
     will report to their classroom before coming
     to church; 8th graders will be presented with  
     their bibles at the end of mass.
20 Catechetical Sunday observation
21 PSR classes
28 PSR classes

5  PSR classes     
12 PSR classes
19 PSR classes
        **22 (Thursday) First Reconciliation Parent
     Meeting 7:00pm at St. Al’s **
26 PSR classes

  2   PSR classes
             9  PSR classes
      ** 11 (Wednesday) Confirmation Retreat – 
                  details to follow –( no school due to
                  Veterans Day observation) **
             16 PSR classes           
  23 Thanksgiving break – NO PSR
  30 PSR classes (1st week of Advent)
7 PSR classes
        **12 (Saturday) 1st Reconciliation Celebration
     10:00 am in St. Jude Church **
14 PSR classes
21 Christmas break – NO PSR
            28 Christmas break – NO PSR

4 PSR classes  
            11 PSR classes – ACRE test for 5th & 8th
            18 Martin Luther King Day – NO PSR
            25 PSR classes–make-up date for ACRE test
        **28 (Thursday) First Eucharist Parent
      Meeting 7:00pm at St. Al’s **



            1   PSR classes
8 PSR classes
15  President’s Day – NO PSR
        **17 (Wednesday) Confirmation Practice in
     church at 7pm **
        **21 (Sunday) Confirmation celebrated at St.   
     Jude 2:00pm in church **
22 PSR classes
29 PSR classes 

7  PSR classes
14 PSR classes
21 Holy Week – NO PSR
            28 Easter Break – NO PSR   

        ** 2 (Saturday) Jesus Day Retreat & 1st
               Communion practice for PSR & School 2nd
   graders in Church undercroft from 9:00 am 
    to 12:30 pm Attendance required! **
4 PSR classes
     ** 10 (Sunday) 1st Communion Celebration
   1:oopm mass – pictures in church after
   Mass **
          11 PSR classes
          18 PSR classes
          25 PSR classes
           4 PSR Closing mass in church – students will
              report to their classroom first.

** Special dates related to sacramental celebrations **