New Registration

PSR Enrollment for the 2019-2020 school year is grades K-7 only.

Please register for 8th grade Edge Youth Ministry by contacting Caitlyn Chickey (chickeyc@assumptionstl.org).

What is the family's name? REQUIRED Please fill out this field. Please enter valid data.

What is the number of children you are registering? REQUIRED Please fill out this field.
Child 1
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Birthday: REQUIRED Please fill out this field. Please enter valid data.
- Please list the sacraments that they each have received (Baptism, Reconciliation, Eucharist) thus far. REQUIRED Please fill out this field. Please enter valid data.
- Please list the date of baptism & the church in which this child was baptized. REQUIRED Please fill out this field. Please enter valid data.
- School they attend: REQUIRED Please fill out this field. Please enter valid data.
- Grade level: REQUIRED Please fill out this field. Please enter valid data.
- Please state the medical, behavioral needs, and/or allergies of the child: Please enter valid data.
- Does this child have an IEP (individualized education program) on file? REQUIRED Yes No Please fill out this field.
- Child's physician: REQUIRED Please fill out this field. Please enter valid data.
- Physician's phone number: REQUIRED Please fill out this field. Please enter valid data.
- Physician's emergency phone number: REQUIRED Please fill out this field. Please enter valid data.
- Child's insurance provider: REQUIRED Please fill out this field. Please enter valid data.
- Child's member ID: REQUIRED Please fill out this field. Please enter valid data.
Child 2
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Birthday: REQUIRED Please fill out this field. Please enter valid data.
- Please list the sacraments that they each have received (Baptism, Reconciliation, Eucharist) thus far. REQUIRED Please fill out this field. Please enter valid data.
- Please list the date of baptism & the church in which this child was baptized. REQUIRED Please fill out this field. Please enter valid data.
- School they attend: REQUIRED Please fill out this field. Please enter valid data.
- Grade level: REQUIRED Please fill out this field. Please enter valid data.
- Please state the medical, behavioral needs, and/or allergies of the child: Please enter valid data.
- Does this child have an IEP (individualized education program) on file? REQUIRED Yes No Please fill out this field.
- Child's physician: REQUIRED Please fill out this field. Please enter valid data.
- Physician's phone number: REQUIRED Please fill out this field. Please enter valid data.
- Physician's emergency phone number: REQUIRED Please fill out this field. Please enter valid data.
- Child's insurance provider: REQUIRED Please fill out this field. Please enter valid data.
- Child's member ID: REQUIRED Please fill out this field. Please enter valid data.
Child 3
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Birthday: REQUIRED Please fill out this field. Please enter valid data.
- Please list the sacraments that they each have received (Baptism, Reconciliation, Eucharist) thus far. REQUIRED Please fill out this field. Please enter valid data.
- Please list the date of baptism & the church in which this child was baptized. REQUIRED Please fill out this field. Please enter valid data.
- School they attend: REQUIRED Please fill out this field. Please enter valid data.
- Grade level: REQUIRED Please fill out this field. Please enter valid data.
- Please state the medical, behavioral needs, and/or allergies of the child: Please enter valid data.
- Does this child have an IEP (individualized education program) on file? REQUIRED Yes No Please fill out this field.
- Child's physician: REQUIRED Please fill out this field. Please enter valid data.
- Physician's phone number: REQUIRED Please fill out this field. Please enter valid data.
- Physician's emergency phone number: REQUIRED Please fill out this field. Please enter valid data.
- Child's insurance provider: REQUIRED Please fill out this field. Please enter valid data.
- Child's member ID: REQUIRED Please fill out this field. Please enter valid data.
Child 4
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Birthday: REQUIRED Please fill out this field. Please enter valid data.
- Please list the sacraments that they each have received (Baptism, Reconciliation, Eucharist) thus far. REQUIRED Please fill out this field. Please enter valid data.
- Please list the date of baptism & the church in which this child was baptized. REQUIRED Please fill out this field. Please enter valid data.
- School they attend: REQUIRED Please fill out this field. Please enter valid data.
- Grade level: REQUIRED Please fill out this field. Please enter valid data.
- Please state the medical, behavioral needs, and/or allergies of the child: Please enter valid data.
- Does this child have an IEP (individualized education program) on file? REQUIRED Yes No Please fill out this field.
- Child's physician: REQUIRED Please fill out this field. Please enter valid data.
- Physician's phone number: REQUIRED Please fill out this field. Please enter valid data.
- Physician's emergency phone number: REQUIRED Please fill out this field. Please enter valid data.
- Child's insurance provider: REQUIRED Please fill out this field. Please enter valid data.
- Child's member ID: REQUIRED Please fill out this field. Please enter valid data.

Mother's full name: REQUIRED Please fill out this field. Please enter valid data.

Mother's cell phone number: REQUIRED Please fill out this field. Please enter valid data.

Mother's home phone number: REQUIRED Please fill out this field. Please enter valid data.

Mother's email address: REQUIRED Please fill out this field. Please enter valid data.

Mother's address: REQUIRED Please fill out this field. Please enter valid data.

Mother's religion: REQUIRED Please fill out this field. Please enter valid data.

Father's full name: REQUIRED Please fill out this field. Please enter valid data.

Father's cell phone number: REQUIRED Please fill out this field. Please enter valid data.

Father's home phone number: Please enter valid data.

Father's email address: REQUIRED Please fill out this field. Please enter valid data.

Father's address: REQUIRED Please fill out this field. Please enter valid data.

Father's religion: REQUIRED Please fill out this field. Please enter valid data.

Is your family registered at Assumption? If not, where? REQUIRED Please fill out this field. Please enter valid data.

What is the marital status of the parents? REQUIRED Married Separated Divorced Remarried Widowed Single Please fill out this field.

In the case of divorce/separation, with whom does the child or children reside? Please enter valid data.

Notice for Divorced Parents:

The Archdiocese of St. Louis' policy requires all divorced parents to submit a copy of your current child custody agreement upon registering your child or children in the Assumption PSR program. It the parents' responsibility to inform the PSR principal and provide a copy of the updated custody agreement upon any change in the agreement.

Baptismal Certificates:

Parents must provide a copy of their child's ***baptismal certificate*** when they enroll their child(ren) for the first time in the Parish School of Religions. HOWEVER, if your child was baptized at Assumption, this is NOT necessary, as the parish office will provide those to the PSR. Please list the date of baptism and the church of baptism for each child.

Emergency Contacts:

These should be either a relative or friend who will assume temporary care of your child(ren) if you cannot be reached.

Who is the #1 emergency contact for your family and their relationship to the child(ren)? REQUIRED Please fill out this field. Please enter valid data.

#1 emergency contact's cell phone: REQUIRED Please fill out this field. Please enter valid data.

#1 emergency contact's secondary phone: REQUIRED Please fill out this field. Please enter valid data.

Who is the #2 emergency contact for your family and their relationship to the child(ren)? REQUIRED Please fill out this field. Please enter valid data.

#2 emergency contact's cell phone: REQUIRED Please fill out this field. Please enter valid data.

#2 emergency contact's secondary phone: REQUIRED Please fill out this field. Please enter valid data.

EMERGENCY CARE PROCEDURE:

In case of accident or serious illness, I request the PSR to contact me. If the PSR is unable to reach me, I hereby authorize the PSR to call the physician indicated above and to follow instructions. If it is impossible to contact this physician, the PSR may make whatever arrangements seem necessary. By submitting this online form, I hereby verify that I am one of the child(ren)'s parents and I consent to this emergency care procedure.

Registration Fees:

To register 1 child, tuition is $175.
For ny additional 2nd or 3rd child registered, tuition is $30 each.
After 3 children, each additional child is free!

For non-parishioners, there is an additional fee of $50.

Sacramental Fees:

2nd grade (First Reconciliation + First Holy Communion) -- $30
7th grade (Confiramtion) -- $45

Total Tuition and Fees due by December 1, 2019.

Contact Mrs. Connors at connorsj@assumptionstl.org for payment plans or financial assistance.

How to pay for your child(ren)'s spot(s):

Pay online! (The payment feature of our website is currently under construction, but you can pay through your Online Giving account. Don't have an account set up? It will only takes a few minutes to set yours up today! Go to https://www.osvonlinegiving.com/1447.)

Or, you can return a check/cash for the amount to the Parish Office by mailing it to 4709 Mattis Rd St. Louis, MO 63128 or by dropping it off! (Our office hours are M-F, 8:30-4:30). You can also return it by dropping your envelope in the Sunday collection basket at Mass, if that's more convenient for you!

If writing a check, please make it out to "Assumption Parish". Please place any monies directed towards PSR registration in an envelope clearly marked for PSR and Mrs. Connors. Thank you!

Additional Forms to complete:

To complete your registration, please pay the amount you owe and by additionally completing and turning in the 2019 Christian Witness Statement & Media Release forms on the first day of PSR! (Or, you can return them to the parish office with your registration money!)

Assumption-Mattese

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If You Are A New Family,
please submit the form below to register: