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(321) 636-6834

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1136 Seminole Drive, Rockledge FL 32955

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info@stmaryrockledge.org
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Religious Education Registration

Online registration is available below or click here to print PDF file.

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Contact Details

Student Name(Required)
Gender(Required)
MM slash DD slash YYYY
Birth City/State/Country(Required)
School(Required)
Please list any allergies or medical conditions.
Baptism(Required)
MM slash DD slash YYYY
Church of Baptism(Required)
First Communion(Required)
MM slash DD slash YYYY
Church of First Communion(Required)
Confirmation(Required)
MM slash DD slash YYYY
Church of Confirmation(Required)
Student #2 Name(Required)
MM slash DD slash YYYY
Birth City/State/Country(Required)
School(Required)
Please list any allergies or medical conditions.
Baptism (Student #2)(Required)
MM slash DD slash YYYY
Church of Baptism(Required)
First Communion (Student #2)(Required)
MM slash DD slash YYYY
Church of First Communion(Required)
Confirmation (Student #2)(Required)
MM slash DD slash YYYY
Church of Confirmation(Required)

Parent / Parishoner Information

Father's Name(Required)
Mother's Name(Required)
Email(Required)
Address(Required)
Is family registered at St. Mary Catholic Church?(Required)

Emergency Contact

Please list the order in which you would like us to reach you in an emergency.
Emergency Contact # 1(Required)
Emergency Contact # 2(Required)
Emergency Contact # 3
You agree to photo/video image release?(Required)
Clear Signature

Payment Details

Fees are due at registration and are non-refundable. The sacrament fee is in addition to the Faith Formation Fee.
Faith Formation Registration Fee(Required)
Sacrament Registration Fee(Required)
Payment(Required)
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Credit Card

Additional information regarding payments will be provided once registration is submitted.

Contact Us

1136 Seminole Drive Rockledge, FL 32955

(321) 636-6834

Quick Links

Online Giving Livestream Safe Environment Training ibreviary USCCB Daily Readings USCCB Lecturas Diarias Catholic Charities Florida Conference of Catholic Bishops Catechism of the Catholic Church Natural Family Planning

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