IREP

				
							Registration Update
						The Tuesday Kindergarten class is full.
The Tuesday 1st Grade class is full.
The Tuesday 2nd Grade class is full.

IREP Registration

"*" indicates required fields

Child Information

Child's Name*

First Last

Child Known As

Child Date of Birth*

Child Sex

Home Parish*

Parish Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Child School*

Child School Grade (starting September)*

Child Most Recently Completed Religious Education Year*

Child Previously Attended Religious Education Program*

Medical Information

The following information is needed to best serve your child, especially in case of an emergency. It will be kept private:

Medications
Allergies/Food Sensitivities
Learning Needs
Physical Disabilities
Additional Comments

Medical Information

Does your child receive accomodations at school?*

Please list accomodations below:*

Does your child have a paraprofessional?*

Sacramental Background

Has Child Been Baptized?*

Yes

Child Baptismal Church

Child Baptismal Church Location

Child Baptism Date

If your child was not baptized at St. Ignatius NYC, please upload a copy of the baptismal certificate.

Max. file size: 50 MB.

Has Child Completed First Communion?*

Yes

Child First Communion Church

Child First Communion Church Location

Child First Communion Date

Child Family Information

Person with Whom Child Lives First Name*

First Last

Person with Whom Child Lives Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Person with Whom Child Lives Telephone*

Person with Whom Child Lives Email*

Parent 1 Name*

First Last

Parent 1 Religion*

Parent 2 Name*

First Last

Parent 2 Religion*

Mother Maiden Name (if different)

Marital Status of Parents*

Emergency Contact Information

Emergency Contact Name*

First Last

Emergency Contact Phone Number*

Emergency Contact Relationship to Child*

Session Selection*

Do You Give Your Child Permission to Self-Dismiss (6, 7, 8 Grade ONLY)

Tuition Payment Method*

Request Financial Aid

Yes

Photo/Video Release

I give the Interparish Religious Education Program of the Church of St. Ignatius Loyola, New York, permission to publish in print, electronic, or video format the words, image, and/or voice of my child ("Minor").*

I release all claims against the Church of St. Ignatius Loyola, New York, with respect to copyright ownership and publication including any claim for compensation related to the use of the materials. I hereby waive any right that I may have to inspect and/or approve the finished product or the copy that may be used in connection therewith, wherein Minor’s likeness appears, or the use to which it may be applied. By submitting this form, I represent that I am at least 18 years of age and am the parent/guardian/legal representative of the above-named Minor. I have read the foregoing agreement and am familiar with all of the terms and conditions thereof and I consent to its execution by the Minor. I agree that neither I nor the Minor will revoke or disaffirm this agreement at any time.

Please note:

Tuition is due by September 30, 2023
Tuition does NOT include sacramental fees
Seats are given on a first come, first serve basis—be sure to register your child to guarantee a seat.

IREP

Registration Update

IREP Registration

Child Information

Medical Information

Sacramental Background

Child Family Information

Emergency Contact Information

Photo/Video Release

Sign up for our weekly newsletter