At the end of the form, you will be provided a secure online payment link.


 NOTE: Students are not registered in a class until both the registration form and
 payment are received.

 * If you have not formally registered with the parish, please attend the Welcoming
 Event on September 17, 2017.

 *****SACARAMENTS: Please select YES for the sacraments your child NEEDS THIS
 YEAR.*****

Click Submit Form to send this information to Emmaus Catholic Parish.

*Required fields

Instructions NOTE: Students are not registered in a class until both the registration form and payment are received. *If you have not formally registered with the parish, please attend the Welcoming Event on August 20, 2017.

Student 1
*First Name *Last Name
  Middle Name
*Birth Date *Gender Female   Male
*Grade/Degree *Photo Consent   Language
*Class Choices
*Class 1
Student Remarks
  General Remarks
  Health Problems

Emergency #
*First Name *Last Name
  Relationship
Emergency #
Note: If you would like to receive a text message when your parish sends a quick communication,
select your provider from the Description drop-down list. Standard text messaging rates apply.
*Primary ( ) - Unlisted

Authorized Pickup
*First Name *Last Name
  Relationship
Alt Pickup #
Note: If you would like to receive a text message when your parish sends a quick communication,
select your provider from the Description drop-down list. Standard text messaging rates apply.
  Other ( ) - Unlisted

*Family Option  New Family Information  Update Existing Family Information ID/Env:  

Head of Household
*First Name *Last Name
  Middle Name Maiden Name
*Gender Female   Male
  Language Marital Status

Spouse
  First Name   Last Name
Relationship   Middle Name
  Language

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

Family Phone Numbers
Note: If you would like to receive a text message when your parish sends a quick communication,
select your provider from the Description drop-down list. Standard text messaging rates apply.
*Primary ( ) - Unlisted
  Other ( ) - Unlisted
Family Email Address
*Email   Unlisted


*Registration Payment (Required)
Note: Please fill out the Head of Household and Family Street Address sections above before entering payment information.
Total Amount (Calculated Automatically)                 
 ?  Payment Help

Click Enter Payment Information to see the secure page provided by Vanco Payment Solutions.

When you are finished, click Save in the Vanco window to continue on this form.

Click Submit Form to send this information to Emmaus Catholic Parish.