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St. Benedict's Catholic Church
TERRE HAUTE, INDIANA, USA
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Home
Welcome: About Us
Staff
Pastoral Council
Finance Council
Contact Us
Welcome Newcomers!
Register
Resources
Prayer Request
History
Windows of St Benedict Church
Tour
Liturgy & Sacraments
Mass & Confession Times
ADVENT & CHRISTMAS
Baptism
Eucharist
Confirmation
Reconciliation
Anointing of the Sick
Marriage
Holy Orders
Ministries & Activities
Ministries
Liturgical Ministry
Activities
Religious Education
Children's Religious Education
Religious Education Registration
High School Youth Ministry
Young Adult Ministry (FRAYAM)
Adult Faith Formation
Becoming Catholic (OCIA)
Returning Catholic
Events
Parish Calendar
Bulletins
News
Photo Albums
Homilies by Friar Martin
Online Giving
Online Giving
Religious Education
Religious Education
Children's Religious Education
Religious Education Registration
High School Youth Ministry
Young Adult Ministry (FRAYAM)
Adult Faith Formation
Becoming Catholic (OCIA)
Returning Catholic
LINKS
Religious Education Calendar 2024-25
Catechism of the Catholic Church online
United States Catholic Catechism for Adults, online
Religious Ed Calendar 2024-25
Religious Education Calendar 2024-25
St. Benedict Religious Education Registration 2024-2025
The maximum number of form submissions has been reached. This form is currently not available.
Is your family registered at St. Benedict's Parish?
REQUIRED
Yes
No
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If not registered at St. Benedict's, in what parish are you registered?
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Family Information
Family Name
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Address 1
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Address 2
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City
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State
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Zip
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Father's Name & Religion
REQUIRED
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Mother's Name & Mother's Maiden Name & Religion
REQUIRED
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Primary Phone Number
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Maximum 20 characters
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Secondary Phone Number
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Preferred Email
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Please enter an email address.
My Contact Preference:
REQUIRED
E-Mail
Text
Flocknote
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Child resides with:
REQUIRED
Mother & Father
Mother
Father
Other
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Check here if parents are divorced
Who is the custodial parent/guardian?
May non-custodial parent receive reports on child? Please respond below.
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May non-custodial parent receive reports on child(ren)?
Yes
No
In the event of an emergency where medical treatment is required, I give my permission to the parish staff to administer first aid and/or obtain the services of a licensed physician.
REQUIRED
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No
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Emergency Contact (First and Last Name):
REQUIRED
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Emergency Contact Relationship
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Emergency Phone Number
REQUIRED
Maximum 20 characters
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Please enter a phone number.
St. Benedict Media Release-permission for your child(ren)'s picture to appear in various media outlets
REQUIRED
Would you please give your permission for your child's picture and name to appear in St. Benedict's media releases such as St. Benedict's website, Facebook page, parish bulletin, parish videos and other parish media releases?
Yes
No
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Children to Register
REQUIRED
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Child 1
First Name
REQUIRED
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Last Name
REQUIRED
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Birthdate (mm/dd/yy)
REQUIRED
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Gender
REQUIRED
Male
Female
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Grade
REQUIRED
(Select One)
Kindergarten
1
2
3
4
5
6
7
8
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Sacraments Completed
REQUIRED
Baptism
Eucharist
Reconciliation
Confirmation
None
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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.
Birthdate (mm/dd/yy)
REQUIRED
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Please enter valid data.
Gender
REQUIRED
Male
Female
Please fill out this field.
Grade
REQUIRED
(Select One)
Kindergarten
1
2
3
4
5
6
7
8
Please fill out this field.
Sacraments Completed
REQUIRED
Baptism
Eucharist
Reconciliation
Confirmation
None
Please fill out this field.
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.
Birthdate (mm/dd/yy)
REQUIRED
Please fill out this field.
Please enter valid data.
Gender
REQUIRED
Male
Female
Please fill out this field.
Grade
REQUIRED
(Select One)
Kindergarten
1
2
3
4
5
6
7
8
Please fill out this field.
Sacraments Completed
REQUIRED
Baptism
Eucharist
Reconciliation
Confirmation
None
Please fill out this field.
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.
Birthdate (mm/dd/yy)
REQUIRED
Please fill out this field.
Please enter valid data.
Gender
REQUIRED
Male
Female
Please fill out this field.
Grade
REQUIRED
(Select One)
Kindergarten
1
2
3
4
5
6
7
8
Please fill out this field.
Sacraments Completed
REQUIRED
Baptism
Eucharist
Reconciliation
Confirmation
None
Please fill out this field.
NOTE FOR SECOND GRADE ONLY:
In the 2nd Grade, we prepare for 1st Communion. A baptismal certificate is required for second grade students who are preparing for First Communion. If baptized at St. Benedict, please indicate the year of baptism; our parish office can prepare a baptism certificate. If baptized at another church, please indicate where on the registration form; you will need to provide a copy of the baptismal certificate as soon as possible after the beginning of the school year.
Information needed: Date of baptism, Name of Church, City/Town/State, Father's Name, Mother's Maiden Name. If all information is not entered on the actual certificate, please provide the additional information.
Please inform Sue Butwin PCL if your child has not been baptized.
If baptized at St. Benedict, please enter the year of baptism.
Please enter valid data.
If baptized at another church, please enter the name of the church and baptismal year
Please enter valid data.
If not baptized, please enter here
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I am interested in a pre-school program for my child.
REQUIRED
Yes
No
Please fill out this field.
Additional Details
Special Needs/Medication/Health Condition/Family Situation for each child
Please list child's name & needs. Send procedure plan to parish office if needed. Please include anything we may need to know about your child (ren) such as allergies, special learning needs, health conditions or family situations we should be aware of (for each child). This information will only be shared with the child's catechist.
Parent Signature
REQUIRED
I acknowledge that as the parent/guardian, this information will be submitted to the parish for use in registration.*
Yes
Please fill out this field.
Checks (made payable to St. Benedict Church) and Cash are accepted on the first day of classes OR to go to the St. Ben's webpage and click on the online giving page to pay with Credit/Debit Cards.
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Payment Information
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