Step 1 of 12 - Family Informaton

Are you a registered member of Assumption?*
If No, you must register your family with the Parish Office first before you can register for Religious Education. Click Here to Register
Family Information
FAMILY NAME*
Address
Street Address*
Address Line 2
City*
State*
Zip*

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How many children are you enrolling in the program?*
Will this child be receiving First Communion or Confirmation this year?*
Child's Name*
First Middle Last
Date of Birth*
MM slash DD slash YYYY
Male or Female*
Place of Birth*
City State Zip
Baptized*
Name of Church of Baptism*
Baptism Church*
City State Zip Country
Date of Baptism*
MM slash DD slash YYYY
Upload a copy of the Baptism Certificate
Max. file size: 50 MB.
Baptized as a*
Received First Reconciliation*
Received First Eucharist*
School Attending*
School's City*
Grade Entering Fall 2023 - 1st child*
Class Selection
Please select the best day/time that works for you and your family.**
- Sunday 10:10 a.m - 11:15 a.m
- Tuesday 4:30 p.m. - 5:30 p.m.
Your Child will be attending Religious Education on: Sunday @ 10:10 a.m - 11:15 a.m
Your Child will be attending Religious Education on: Sunday @ 10:10 a.m - 11:15 a.m
Your Child will be attending Religious Education on: Sunday @ 9:00 a.m - 10:00 a.m

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All Information will be kept CONFIDENTIAL
Please indicate any specific circumstances, learning disabilities, or medical disabilities your child may have. It is imperative our teachers be informed of your child's needs.
Allergies (Child One)*
Does your child have food, insect or chemical allergies? (We will do what we can, but your child should know what he/she can or cannot eat).
Please describe your allegies (Child One)*
Does your child have any special medical or medicine needs? (Child One)*
Please describe your special medical or medicine needs (Child One)*
Does your child use an EpiPen? (Child One)*
If your child uses an EpiPen a parent must stay in the building or classroom. (We do not have a nurse on duty and therefore we can only dispense bandaids).
Special Needs (Child One)*
Does your child have an IEP? (Individual Education Program)
Does your child have a full-time aide in school? (Child One)*
Is your child on any medications? (Child One)*
What medications? (Child One)*
Is your child protected by a restraining order? (Child One)*
If so, please write the information necessary to fulfill this decree (Child One)*
Is your child mentioned in a child custody agreement? (Child One)*
If Yes, who is allowed to pick up your child? (Child One)*
Is there anything else we need to know about your child in order to have a safe and productive environment for him/her? (Child One)

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Second Child
Will this child be receiving First Communion or Confirmation this year?*
Child's Name*
First Middle Last
Date of Birth*
MM slash DD slash YYYY
Male or Female*
Place of Birth*
City State Zip
Baptized*
Name of Church of Baptism*
Baptism Church*
City State Zip Country
Date of Baptism*
MM slash DD slash YYYY
Upload a copy of the Baptism Certificate
Max. file size: 50 MB.
Baptized as a*
Received First Reconciliation*
Received First Eucharist*
School Attending*
School's City*
Class Selection
Grade Entering Fall 2023 - 2nd Child*
Please select the best day/time that works for you and your family.**
- Sunday 10:10 a.m - 11:15 a.m
- Tuesday 4:30 p.m. - 5:30 p.m.
Your Child will be attending Religious Education on: Sunday @ 10:10 a.m - 11:15 a.m
Your Child will be attending Religious Education on: Sunday @ 10:10 a.m - 11:15 a.m
Your Child will be attending Religious Education on: Sunday @ 9:00 a.m - 10:00 a.m

Save and Continue Later

All Information will be kept CONFIDENTIAL
Please indicate any specific circumstances, learning disabilities, or medical disabilities your child may have. It is imperative our teachers be informed of your child's needs.
Allergies (Child Two)*
Does your child have food, insect or chemical allergies? (We will do what we can, but your child should know what he/she can or cannot eat).
Please describe your allegies (Child Two)*
Does your child have any special medical or medicine needs? (Child Two)*
Please describe your special medical or medicine needs (Child Two)*
Does your child use an EpiPen? (Child Two)*
If your child uses an EpiPen a parent must stay in the building or classroom. (We do not have a nurse on duty and therefore we can only dispense bandaids).
Special Needs (Child Two)*
Does your child have an IEP? (Individual Education Program)
Does your child have a full-time aide in school? (Child Two)*
Is your child on any medications? (Child Two)*
What medications? (Child Two)*
Is your child protected by a restraining order? (Child Two)*
If so, please write the information necessary to fulfill this decree (Child Two)*
Is your child mentioned in a child custody agreement? (Child Two)*
If Yes, who is allowed to pick up your child? (Child Two)*
Is there anything else we need to know about your child in order to have a safe and productive environment for him/her? (Child Two)

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Third Child
Will this child be receiving First Communion or Confirmation this year?*
Child's Name*
First Middle Last
Date of Birth*
MM slash DD slash YYYY
Male or Female*
Place of Birth*
City State Zip
Baptized*
Name of Church of Baptism*
Baptism Church*
City State Zip Country
Date of Baptism*
MM slash DD slash YYYY
Upload a copy of the Baptism Certificate*
Max. file size: 50 MB.
Baptized as a*
Received First Reconciliation*
Received First Eucharist*
School Attending*
School's City*
Grade Entering Fall 2023 - 3rd child*
Please select the best day/time that works for you and your family.**
- Sunday 10:10 a.m - 11:15 a.m
- Tuesday 4:30 p.m. - 5:30 p.m.
Your Child will be attending Religious Education on: Sunday @ 10:10 a.m - 11:15 a.m
Your Child will be attending Religious Education on: Sunday @ 10:10 a.m - 11:15 a.m
Your Child will be attending Religious Education on: Sunday @ 9:00 a.m - 10:00 a.m

Save and Continue Later

All Information will be kept CONFIDENTIAL
Please indicate any specific circumstances, learning disabilities, or medical disabilities your child may have. It is imperative our teachers be informed of your child's needs.
Allergies (Child Three)*
Does your child have food, insect or chemical allergies? (We will do what we can, but your child should know what he/she can or cannot eat).
Please describe your allegies (Child Three)*
Does your child have any special medical or medicine needs? (Child Three)*
Please describe your special medical or medicine needs (Child Three)*
Does your child use an EpiPen? (Child Three)*
If your child uses an EpiPen a parent must stay in the building or classroom. (We do not have a nurse on duty and therefore we can only dispense bandaids).
Special Needs (Child Three)*
Does your child have an IEP? (Individual Education Program)
Does your child have a full-time aide in school? (Child Three)*
Is your child on any medications? (Child Three)*
What medications? (Child Three)*
Is your child protected by a restraining order? (Child Three)*
If so, please write the information necessary to fulfill this decree (Child Three)*
Is your child mentioned in a child custody agreement? (Child Three)*
If Yes, who is allowed to pick up your child? (Child Three)*
Is there anything else we need to know about your child in order to have a safe and productive environment for him/her? (Child Three)

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Fourth Child
Will this child be receiving First Communion or Confirmation this year?*
Child's Name*
First Middle Last
Date of Birth*
MM slash DD slash YYYY
Male or Female*
Place of Birth*
City State Zip
Baptized*
Name of Church of Baptism*
Baptism Church*
City State Zip Country
Date of Baptism*
MM slash DD slash YYYY
Upload a copy of the Baptism Certificate*
Max. file size: 50 MB.
Baptized as a*
Received First Reconciliation*
Received First Eucharist*
School Attending*
School's City*
Grade Entering Fall 2023 -4th Child*
Please select the best day/time that works for you and your family.**
- Sunday 10:10 a.m - 11:15 a.m
- Tuesday 4:30 p.m. - 5:30 p.m.
Your Child will be attending Religious Education on: Sunday @ 10:10 a.m - 11:15 a.m
Your Child will be attending Religious Education on: Sunday @ 10:10 a.m - 11:15 a.m
Your Child will be attending Religious Education on: Sunday @ 9:00 a.m - 10:00 a.m

Save and Continue Later

All Information will be kept CONFIDENTIAL
Please indicate any specific circumstances, learning disabilities, or medical disabilities your child may have. It is imperative our teachers be informed of your child's needs.
Allergies (Child Four)*
Does your child have food, insect or chemical allergies? (We will do what we can, but your child should know what he/she can or cannot eat).
Please describe your allegies (Child Four)*
Does your child have any special medical or medicine needs? (Child Four)*
Please describe your special medical or medicine needs (Child Four)*
Does your child use an EpiPen? (Child Four)*
If your child uses an EpiPen a parent must stay in the building or classroom. (We do not have a nurse on duty and therefore we can only dispense bandaids).
Special Needs (Child Four)*
Does your child have an IEP? (Individual Education Program)
Does your child have a full-time aide in school? (Child Four)*
Is your child on any medications? (Child Four)*
What medications? (Child Four)*
Is your child protected by a restraining order? (Child Four)*
If so, please write the information necessary to fulfill this decree (Child Four)*
Is your child mentioned in a child custody agreement? (Child Four)*
If Yes, who is allowed to pick up your child? (Child Four)*
Is there anything else we need to know about your child in order to have a safe and productive environment for him/her?

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Father's Name*
Prefix First Last
Religion*
Home Phone
Work Phone
Cell Phone*
Please provide a cell phone number we may use to contact you via text message in the event of a cancellation or emergency.
Email*
Mother's Name*
Prefix First Last
Mother's Maiden Name
Religion*
Home Phone
Work Phone
Cell Phone*
Please provide a cell phone number we may use to contact you via text message in the event of a cancellation or emergency.
Email*
Are the parents*
Child lives with*
- Both Parents
- Mother
- Father
- Other
Emergency Contact other than the Parents*
First Last
Relationship to child*
Emergency Contact Phone/Cell Phone*

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We are in the process of obtaining our parent volunteers for the Religious Education year 2022 –2023. Our religious education program is a cooperative effort. We rely on volunteers to coordinate, teach, be an aide in class or substitute. We do need your help for students’ safety, learning environment, and hospitality. Please volunteer for something you would enjoy doing.
I would be willing to:
- Teach/Co-teach a class on: Sunday at 9am to 10:10am - Grade 7 or 8 Confirmation Prep
- Teach/Co-teach a class on: Sunday at 10:10am to 11:15am Grade 2, 3, 4, 5
- Teach/Co-teach a Grade 2, 3, 4, 5 Class on: Tuesday at 4:30pm to 5:30pm,
- Tuition Fees are waived if you volunteer to teach/co teach
- I will substitute as needed for any class Tuesday or Sunday
- I will be the second adult in class on a weekly basis. (We need one per class)
- I will be a door monitor before classes begin on Sunday and Tuesday
- I will bake for parish events and gatherings
- I will volunteer to do one Coffee Sunday after the 9am Mass (can be done with others)

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Consent & Payment
Expectations*
I understand that regular attendance at class is expected and that it is my child's responsibility to complete all assigned readings and homework should he/she be absent. I further understand if my child misses class more than (3) consecutive times, he/she will be asked to come to the Religious Education Office for make up materials. Continued disruptive behavior during class will result in a parent attending class with their child.
- I agree with the statement above
Permission to Photograph & Release*
I hereby give permission to the Roman Catholic Diocese of Bridgeport (the "Diocese") and its agents and representatives to take photographs, make artistic renderings and make film, video or audio recordings of me and those of my child(ren) whose name(s) is/are set forth in this registration. In addition, I hereby give permission to the Diocese to use my and their names and use such photographs, renderings, film, video and audio recordings in perpetuity, in any manner deemed appropriate by the Diocese, in any media, including, without limitation print, video and web-based uses. I agree that the Diocese has complete editorial discretion with regard to use of such materials and that I will not be compensated in any way for any such use. I release and forever discharge the Diocese, its affiliates, officers, agents, representatives, successors and assigns from any and all claims, costs, liabilities and expenses arising from any use of such materials including, without limitation, any claims of invasion of privacy, defamation, violation of publicity rights and hereby agree to indemnify and hold the Diocese and its agents harmless from and against any such claims. If any subject is a minor: I represent that I can and I am the parent or legal guardian of the minor(s) identified in this registration and I hereby agree that we both shall be bound by this release.
- I agree to the statement above
Registration Fee: Total
One Child - $260
Two Children - $400
Three or More Children - $450
Note: there is a $100 additional charge for First Communion and/or Confirmation Students

I agree to pay the stated registration fee for my child(ren). I understand that registration will not be processed until payment has been received in full. If you have financial concerns or a credit card payment is not possible, please contact our office at 203-226-5448.
$0.00
Credit Card*
Card Details
Cardholder Name
Email
This field is for validation purposes and should be left unchanged.

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Church of the Assumption

98 Riverside Avenue
Westport, CT 06880

Parish Office: 203-227-5161
Religious Education: 203-226-5448

New to the Parish?
Please Click Here to Register

Mass Times

Weekend Schedule

Saturday: 5:00 pm

Sunday: 7:30am, 9:00am, 11:00am, 5:00pm

Daily (Monday – Saturday)

Weekday Masses: 7:30am

Reconciliation

Saturday 4:00pm – 4:45pm or by appointment

City	State	Zip	Country

City	State	Zip	Country

City	State	Zip	Country

City	State	Zip	Country

Step 1 of 12 - Family Informaton

Family Information

Address

Class Selection

All Information will be kept CONFIDENTIAL

Second Child

Class Selection

All Information will be kept CONFIDENTIAL

Third Child

All Information will be kept CONFIDENTIAL

Fourth Child

All Information will be kept CONFIDENTIAL

Consent & Payment

Church of the Assumption

Mass Times

Weekend Schedule

Daily (Monday – Saturday)

Reconciliation