Welcome to our Parish School of Religion online registration for 2021-2022. Returning and
 new PSR students should re-enroll through this process. You must be a registered member of
 Saint Rose of Lima for your children to enroll in our PSR Program and before completing this
 form. You may register to be a parishioner on the website. Please contact the church office at
 (615) 893-1843 if you have any questions.

Click Submit Form to send this information to Saint Rose of Lima Catholic Church.

*Required fields

Form's Instructions Special Instructions for filling out this form (Under Student Remarks):
General Remarks Box: Please indicate whether your child will be Distant learning or homeschooling for the year. Please list any church where your child recieved a sacrament.
Health Problems Box: please share any health concerns- Allergies, Epi Pen and any medications. Special needs (physical or learning disabilities).
Family Remarks: Please list an emergency contact name and number in the event your child is sick during class. If any unusual situation that needs addressing, please contact Christina Bien (ext. 1001)
Below this registration link on the main website page, there will be a payment link if you would like to pay online. Alternatively, you may mail or drop off a check made out to Saint Rose Catholic Church at the church office. The fee amounts will be listed on this link as well as information if financial assistance is needed.

Family Options  New Family  Update Existing Family   ID Number: 
  Call Saint Rose of Lima Catholic Church at (615) 893-1843, if you do not know your ID Number.

Head of Household
Title *First Name *Last Name Suffix
*Relationship   Middle Name Maiden Name
Ethnicity *Gender Female   Male
  Language *Marital Status
*Phone 1 ( ) - Unlisted
  Email 1   Unlisted

Spouse
Title   First Name   Last Name Suffix
Relationship   Middle Name Maiden Name
Ethnicity   Gender Female   Male
  Language Marital Status
  Phone 1 ( ) - Unlisted
  Email 1   Unlisted

Family Street Address
*Line 1
  Line 2
*City
*State
*ZIP

Family Phone Numbers
*Primary ( ) - Unlisted
  Other ( ) - Unlisted
Family Email Address
*Email   Unlisted
Family Remarks
*Remarks

Student 1
*First Name *Last Name Suffix
  Middle Name   Nickname
Ethnicity *Birth Date *Gender Female   Male
*Grade/Degree *Language
  Phone:6th-12th ( ) - Unlisted
  Email:6th-12th   Unlisted
Sacraments   Name Received Date Place
*Baptism
*First Reconciliation
   First Comm
*Confirmation
Student Remarks
  General Remarks
  Health Problems
  Other Conditions
  Remarks


Click Submit Form to send this information to Saint Rose of Lima Catholic Church.

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