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, 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 '25-'26 Academic YearKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th GradeBirth 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 applicableYearGradeKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th GradeMedications 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 '25-'26 Academic YearKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th GradeBirth 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 applicableYearGrade for '25-'26 Academic YearKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th GradeMedications 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 '25-'26 Academic YearKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th GradeBirth 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 applicableYearGrade for '25-'26 Academic YearKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th GradeMedications 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 '25-'26 Academic YearKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th GradeBirth 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 applicableYearGradeKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th GradeMedications 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 '25-'26 Academic YearKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th GradeBirth 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 applicableYearGradeKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th GradeMedications 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 childI authorize the Incarnation Staff to summon emergency medical treatment in the event my child/children become seriously ill or injured, and I further release Incarnation Staff and the Diocese of Memphis from any and all liability and waive any claims against them regarding any accident or injury by participating in any activities of an Incarnation program. My signature gives Incarnation Church permission to photograph or videotape my child at Incarnation PRE or any PRE activity. This photo may be published in the newspaper, church website, or weekly bulletin. *(If not, please attach your decline in writing) The VIRTUS Teaching Safety- Empowering God’s Children will be presented in the PRE program each year. This program is an implementation of the Charter for the Protection of Children and Young People adopted in 2002 by our nation’s bishops. Note: Any parent is permitted to “opt out” of the VIRTUS Teaching Safety Program for Children, excluding their child from this presentation. To opt out, please contact the PRE department. Release of Liability 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