PRE Registration Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Family (layout)Family Last Name *LanguageEnglishSpanishHome PhonePrimary Email *Secondary EmailAddressAddress Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeFlocknote CellCell Phone Number to be used for FLOCKNOTE COMMUNICATIONS from this office:FatherFather (layout)Father's Name *Work / CellReligionCatholicNon-Catholic ChristianOtherPlease SpecifyMotherMother (layout)Mother's Name *Work / CellReligionCatholicNon-Catholic ChristianOtherPlease SpecifyLayoutSunday, During 10:30 a.m. MassFor 3,4 year oldsSunday, 9:00 a.m. – 10:15 a.m.Grades K thru 7,Confirmation Prep Grades 8-12Wednesday, 5:30 p.m. – 6:45 p.m.Grades 1 thru 7, Confirmation Prep Grades 8-12, RCIC Grades 3-8Children to RegisterChild #1Child #1 (layout)Name *FirstLastSchoolSexMaleFemaleGrade for '24-'25 Academic YearBirth DateBaptismBaptized?YesNoDatePlace of Baptism1st Communion1st Communion?YesNoDatePlace of 1st Communion1st Reconciliation1st Reconciliation?YesNoConfirmationConfirmed?YesNoDatePlace of ConfirmationLast Religious EducationLast Catholic School or Parish Religious Education AttendedLeave blank if not applicableYearGradeMedications during schoolHealth ConditionsDoes the student have any health conditions of which we should be aware of? (Allergies, Seizures, etc.)Learning DifferencesDoes the student have any special learning differences of which we should be aware? (ADD,ADHD, etc.)Child #2Child #2 (layout)Name *FirstLastSchoolSexMaleFemaleGrade for '24-'25 Academic YearBirth DateBaptismBaptized?YesNoDatePlace of Baptism1st Communion1st Communion?YesNoDatePlace of 1st Communion1st Reconciliation1st Reconciliation?YesNoConfirmationConfirmed?YesNoDatePlace of ConfirmationLast Religious EducationLast Catholic School or Parish Religious Education AttendedLeave blank if not applicableYearGradeMedications during schoolHealth ConditionsDoes the student have any health conditions of which we should be aware of? (Allergies, Seizures, etc.)Learning DifferencesDoes the student have any special learning differences of which we should be aware? (ADD,ADHD, etc.)Child #3Child #3 (layout)Name *FirstLastSchoolSexMaleFemaleGrade for '24-'25 Academic YearBirth DateBaptismBaptized?YesNoDatePlace of Baptism1st Communion1st Communion?YesNoDatePlace of 1st Communion1st Reconciliation1st Reconciliation?YesNoConfirmationConfirmed?YesNoDatePlace of ConfirmationLast Religious EducationLast Catholic School or Parish Religious Education AttendedLeave blank if not applicableYearGradeMedications during schoolHealth ConditionsDoes the student have any health conditions of which we should be aware of? (Allergies, Seizures, etc.)Learning DifferencesDoes the student have any special learning differences of which we should be aware? (ADD,ADHD, etc.)Child #4Child #4 (layout)Name *FirstLastSchoolSexMaleFemaleGrade for '24-'25 Academic YearBirth DateBaptismBaptized?YesNoDatePlace of Baptism1st Communion1st Communion?YesNoDatePlace of 1st Communion1st Reconciliation1st Reconciliation?YesNoConfirmationConfirmed?YesNoDatePlace of ConfirmationLast Religious EducationLast Catholic School or Parish Religious Education AttendedLeave blank if not applicableYearGradeMedications during schoolHealth ConditionsDoes the student have any health conditions of which we should be aware of? (Allergies, Seizures, etc.)Learning DifferencesDoes the student have any special learning differences of which we should be aware? (ADD,ADHD, etc.)Child #5Child #5 (layout)Name *FirstLastSchoolSexMaleFemaleGrade for '24-'25 Academic YearBirth DateBaptismBaptized?YesNoDatePlace of Baptism1st Communion1st Communion?YesNoDatePlace of 1st Communion1st Reconciliation1st Reconciliation?YesNoConfirmationConfirmed?YesNoDatePlace of ConfirmationLast Religious EducationLast Catholic School or Parish Religious Education AttendedLeave blank if not applicableYearGradeMedications during schoolHealth ConditionsDoes the student have any health conditions of which we should be aware of? (Allergies, Seizures, etc.)Learning DifferencesDoes the student have any special learning differences of which we should be aware? (ADD,ADHD, etc.)For sacramental preparation this parish follows the policy set forth by the Catholic Diocese of Memphis. A child must have two consecutive years of formation leading up to reception of any sacrament. *Sacramental year fees are not included in tuition fee. Sacramental year fees per child: 1st Recon. /1st Comm. Fee (2nd gr. or RCIC) $40.00 Confirmation Fee (Confirmation Prep Grades 8-12) $40.00Emergency Contact (layout)Emergency Contact (other than parent) *FirstLastPhoneRelationship to childIn case of medical (or surgical) emergency, I herby give permission to the physician selected by Incarnation Catholic Church DRE or his/ her representative to hospitalize and/or secure proper medical treatment for my above named child. I understand that I am responsible for the cost of any medical treatments (including surgery) received by my child. I hereby release the directors and staff of Incarnation PRE from all responsibility for sickness or accidents, which occur during the PRE school year (or event). I understand that I will be contacted immediately in the case of an emergency.Medical Emergency AuthorizationI authorizeI am enrolling my child in the Incarnation Parish Religious Education program and I understand that as a parent, I am primarily responsible for the on-going religious formation of my child, including regular attendance at Mass, reception of the sacraments, participating in the life of the parish and ensuring my child regularly attend PRE classes.Primary Educator AcknowledgementI acknowledgeNOTE: This form requires a separate payment submission. Once the payment is made, return to this page to submit the registration.Payment StatusI have made the paymentMake your payment here. Select the appropriate item from the drop down menu. Tuition*: 1 Child: $80.00; 2 Children: $150.00; 3 or more Children: $200.00Submit