2017-18 PSR Registration Application

Registration Application | PSR 2017-2018

All the information entered on this application is considered confidential, will not be shared with an outside entity, and will be used only for purposes pertaining to our Parish School of Religion (Immaculate Conception-Baton Rouge) and the Office of Child and Youth Protection (Diocese of Baton Rouge).

REGISTRATION FEES [Payable by cash, check or online] | $25: one child only or first child of a family | $15: for each additional child (sibling) from the same family | $10: additional charge if child is receiving First Holy Communion or Confirmation during 2017-18 PSR School Year


STUDENT'S INFORMATION


STUDENT'S ADDRESS [Where PSR Information Will Be Mailed]


MOTHER'S INFORMATION [Biological/Adoptive]


FATHER'S INFORMATION [Biological/Adoptive]


GUARDIAN'S INFORMATION [Other Than Biological/Adoptive Parent]


EMERGENCY CONTACT'S INFORMATION


LIABILITY WAIVER


PHOTO | VIDEOTAPE RELEASE

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