PSR Registration and Payment

: Parish Partners Parish School of Religion (PSR) Registration and Catechesis of the Good Shepherd (CGS) Registration 2025-26
: Welcome. You are registering for PSR or CGS for the following parishes: Blessed Trinity, Immaculate Heart of Mary, Saint Anthony, and Saint Joseph. PLEASE COMPLETE ONE FORM PER CHILD.

: Please note: sacramental preparation for first reconciliation, first communion, and confirmation are separate from PSR. Ask your home parish for information on sacramental preparation.

: Register for ONE of the following:
PSR/CGS Options:
Are You New to the Program?
: Child's Information
School Grade for 2025-26 Academic Year:
First Name:
Last Name
Current Parish
If you chose "other", please list parish name, city, state.
Street Address:
City:
Zip:
Date of Birth (mm/dd/yyyy):
Date of Baptism (mm/dd/yyyy):
Parish of Baptism
If you chose "other", please list parish name, city, state.
Mother/Guardian First Name:
Mother/Guardian Last Name
Mother/Guardian Cell Phone (ex. 1234567890 -no hyphens):
Mother/Guardian Email Address:
Father/Guardian First Name:
Father/Guardian Last Name
Father/Guardian Cell Phone (ex. 1234567890 - no hyphens):
Father/Guardian Email Address:
Person Responsible for Payment
Person Responsible for Payment Phone (if not already included above)

: Emergency Medical Information
#1 Emergency Contact Name
#1 Emergency Contact Phone (ex. 1234567890 - no hyphens)
#2 Emergency Contact Name:
#2 Emergency Contact Phone (ex. 1234567890 - no hyphens)
Family Doctor Name
Family Doctor Phone
Family Dentist Name
Family Dentist Phone
Please List any Allergies:
Please list any unique qualities we would need to tell Emergency Personnel regarding your child (i.e Autism Spectrum, ADHD, Anxiety, Diabetes, etc...):
Please list anything else that you feel we should know about your child:
EMERGENCY MEDICAL AUTHORIZATION FORM: I hereby give my permission for Saint Joseph Parish Staff or an adult representative of the Parish Partners PSR/CGS program to seek medical attention and treatments deemed necessary for all children named on this registration in the event parents and emergency contacts cannot be reached.: Permission Granted:
YesNo
If answered NO: In the event of illness or injury requiring emergency treatment, I wish the parish authorities to take the following action:

: Permission to Photograph
PERMISSION TO PHOTOGRAPH: I grant permission to Saint Joseph Parish, Blessed Trinity, Saint Anthony, or Immaculate Heart of Mary Parishes to authorize the release, publication, dissemination, distribution, use, and/or reproduction of any and all photographs taken of my daughter/son during her/his enrollment in the Parish Partners PSR/CGS 2025-26 program by an employee, agent, or representative of Saint Joseph, Blessed Trinity, Saint Anthony, or Immaculate Heart of Mary Parishes or independent contractor.: YesNo

: Family Handbook
: As parent or legal guardian of the above child, In consideration of the child being allowed to participate in Parish Partners in Catholic Education Parish School of Religion (PSR), Family PSR, or the Catechesis of the Good Shepherd Program (CGS), on behalf of my child, my spouse, and myself, I hereby assume all risks in connection with PSR/ CGS and I further release, discharge, and/or otherwise indemnify the Diocese of Cleveland, the Bishop of the Roman Catholic Diocese of Cleveland, St. Joseph Parish, Immaculate Heart of Mary Parish, Blessed Trinity Parish, Saint Anthony Parish employees and volunteers from all claims, judgments, liability by or on behalf of my child, myself and my spouse for any injury or damage due to the child's participation in PSR/CGS, including all risks connected there with whether foreseen or unforeseen. Furthermore, I acknowledge that it is my responsibility to provide adequate health insurance for my child. In the event that I cannot be contacted, I hereby give permission to transport my child for emergency medical care in the event of illness or injury to the nearest hospital. I fully understand what is involved in PSR/CGS and I understand that I have the opportunity to call the Pastoral Associate and ask about PSR/CGS. I understand if I grant permission to photograph my child, photographs could be used in future displays and/or parish publications.
I have read the Parish Partners for PSR/CGS Program Polices, as presented in the Handbook. I understand all policies and procedures and have gone over them with my child. I understand and agree that myself and my child will abide by all these policies and procedures.: YesNo

: Sign and date below. Then proceed to payment. Please note: your child is NOT registered until payment is completed.
: Digital Signature and Date
: Typing your name serves as your digital signature and signifies your consent to this agreement.
Signature (type your full name for digital signature):
Date:

PSR Registration and Payment

Parish Partners Parish School of Religion (PSR) Registration and Catechesis of the Good Shepherd (CGS) Registration 2025-26

Please note: sacramental preparation for first reconciliation, first communion, and confirmation are separate from PSR. Ask your home parish for information on sacramental preparation.

Register for ONE of the following:

Child's Information

Emergency Medical Information

Permission to Photograph

Family Handbook

Sign and date below. Then proceed to payment. Please note: your child is NOT registered until payment is completed.

Digital Signature and Date

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