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Holy Rosary Church Renovation
News & Events
Our Faith
Sacraments
Parish Life
School
About Us
- History
- Staff
- Contact
  - Flocknote

Support Our Parish

Holy Rosary Church Renovation
News & Events
Our Faith
Sacraments
Parish Life
School
About Us
- History
- Staff
- Contact
  - Flocknote

Find a Parish
Report Abuse
Diocesan Plan
Safe Environment

Support Our Parish

Diocese

Blog

PSR Online Registration Open

July 30, 2021 | Faith Formation, PSR - Parish School of Religion, Religious Education

Holy Rosary & St. Stephen PSR Registration

"*" indicates required fields

In which Parish is your family registered?*

Today's Date

MM slash DD slash YYYY

Parent/Guardian Information

Parent/Guardian 1 Name*

First Last

Parent/Guardian 2 Name

First Last

Parent/Guardian 1 Email Address*

Parent/Guardian 2 Email Address

Address*

Street Address Address Line 2 City State ZIP Code

Parent/Guardian 1 Primary Phone Number*

Parent/Guardian 2 Primary Phone Number

I would be willing to volunteer for the PSR Program as the following:

Teacher

Aide

Substitute

Chaperone

Provide Food/Snacks

Be an out of town driver for events

Safe Environment Compliance

Parents and Volunteers are required to understand the Safe Environment policies and comply with them when serving in our parish. Please ensure you are compliant with Safe Environment requirements by visiting: diojeffcity.org/safe-environment

Emergency Contact Information

Emergency Contact other than Parent/Guardian*

Grandparent/Aunt/Uncle…someone that can be reached if we are unable to reach the parents/guardians.

Emergency Primary Phone Number*

Emergency Contact Secondary Phone Number

Student Section

How many students are you registering?*

Student #1

Student #1 Name

Please fill out student’s full name.

First Middle Last

Student #1 Birthdate

MM slash DD slash YYYY

Student #1 Grade Level

Please select Student’s grade level

Church of Baptism

Please enter the name of the Church and the City & State in which it is located.

Student #1 Sacraments Received

Please check all the Sacraments your child has received.

Baptism

Reconciliation

Eucharist

Confirmation

Chosen Youth Group

If your child is in high school, would they be interested in the Chosen Youth Group on Wednesday evenings?

Yes

Maybe

SEC Middle School Youth Group

If your child is in 7th or 8th grade, would they be interested in the SEC Youth Group?

Yes

Maybe

Does your child have any health concerns and/or food allergies that we should know?

Yes

If Yes, please explain…

Student #2

Student #2 Name

Please fill out student’s full name.

First Middle Last

Student #2 Birthdate

MM slash DD slash YYYY

Student #2 Grade

Please select Student’s grade level

Church of Baptism*

Please enter the name of the Church and the City & State in which it is located.

Student #2 Sacraments Received

Please check all the Sacraments your child has received.

Baptism

Reconciliation

Eucharist

Confirmation

Chosen Youth Group

If your child is in high school, would they be interested in the Chosen Youth Group on Wednesday evenings?

Yes

Maybe

SEC Middle School Youth Group

If your child is in 7th or 8th grade, would they be interested in the SEC Youth Group?

Yes

Maybe

Does your child have any health concerns and/or food allergies that we should know?

Yes

If Yes, please explain…

Student #3

Student #3 Name

Please fill out student’s full name.

First Middle Last

Student #3 Birthdate*

MM slash DD slash YYYY

Student #3 Sacraments Received

Please check all the Sacraments your child has received.

Baptism

Reconciliation

Eucharist

Confirmation

Student #3 Grade

Please select Student #1 grade level

Church of Baptism

Please enter the name of the Church and the City & State in which it is located.

Chosen Youth Group

If your child is in high school, would they be interested in the Chosen Youth Group on Wednesday evenings?

Yes

Maybe

SEC Middle School Youth Group

If your child is in 7th or 8th grade, would they be interested in the SEC Youth Group?

Yes

Maybe

Does your child have any health concerns and/or food allergies that we should know?

Yes

If Yes, please explain…

Student #4

Student #4 Name

Please fill out student’s full name.

First Middle Last

Student #4 Birthdate

MM slash DD slash YYYY

Student #4 Sacraments Received

Please check all the Sacraments your child has received.

Baptism

Reconciliation

Eucharist

Confirmation

Student #4 Grade

Please select Student’s grade level.

Church of Baptism

Please enter the name of the Church and the City & State in which it is located.

Chosen Youth Group

If your child is in high school, would they be interested in the Chosen Youth Group on Wednesday evenings?

Yes

Maybe

SEC Middle School Youth Group

If your child is in 7th or 8th grade, would they be interested in the SEC Youth Group?

Yes

Maybe

Does your child have any health concerns and/or food allergies that we should know?

Yes

If Yes, please explain…

Student #5

Student #5 Name

Please fill out student’s full name.

First Middle Last

Student #5 Birthdate

MM slash DD slash YYYY

Student #5 Sacraments Received

Please check all the Sacraments your child has received.

Baptism

Reconciliation

Eucharist

Confirmation

Student #5 Grade

Please select Student’s grade level

Church of Baptism

Please enter the name of the Church and the City & State in which it is located.

Chosen Youth Group

If your child is in high school, would they be interested in the Chosen Youth Group on Wednesday evenings?

Yes

Maybe

SEC Middle School Youth Group

If your child is in 7th or 8th grade, would they be interested in the SEC Youth Group?

Yes

Maybe

Does your child have any health concerns and/or food allergies that we should know?

Yes

If Yes, please explain…

Student #6

Student #6 Name

Please fill out student’s full name.

First Middle Last

Student #6 Birthdate

MM slash DD slash YYYY

Student #6 Sacraments Received

Please check all the Sacraments your child has received.

Baptism

Reconciliation

Eucharist

Confirmation

Student #6 Grade

Please select Student’s grade level

Church of Baptism

Please enter the name of the Church and the City & State in which it is located.

Chosen Youth Group

If your child is in high school, would they be interested in the Chosen Youth Group on Wednesday evenings?

Yes

Maybe

SEC Middle School Youth Group

If your child is in 7th or 8th grade, would they be interested in the SEC Youth Group?

Yes

Maybe

Does your child have any health concerns and/or food allergies that we should know?

Yes

If Yes, please explain…

Consent for Direct Communication with Minors

This section is for parents with students in grades 7-12 only. Parents, please read the following:

Child/Children's name(s)*

Please list the name(s) of children in grades 7-12.

Please select an option:*

You may not contact my child directly.

Contact with my child is permissible via the following methods:

Please check the box for each communication method that is permissible.

Phone calls

Text message

The social networking sites sponsored by this ministry (see below)

Social Media used by Holy Rosary and St. Stephen PSR/Youth Ministry

Facebook:

@HolyRosaryMC @HRSSYouthMinistry @HRSSFaithFormation

Instagram:

hr_ssfaithformation

Websites:

www.holyrosary.diojeffcity.org www.ststephenic.diojeffcity.org

Child/Children Phone number

Please enter the name of the child and the allowable phone number to use. If more than one child, please separate with a semi-colon (;).

Child/Children Email address

Please enter the name of the child and the allowable email address to use. If more than one child, please separate entries with a semi-colon (;). We may not be able to contact your child using school email addresses since we are outside the system, please enter a home email.

This form allows you, the parent or guardian, to be aware of the various forms of communication used in your parish’s youth formation programs. It allows you to identify who may communicate directly with your child and by what means. Parents or guardians will always be included on all written or digital communications with their child and will always be granted full access to any digital or social media forum used for parish ministry to young people.

Consent for Direct Communication with Minors*

I have read the section above and understand it.

Verify the above by typing your (parent or guardian) name here to serve as your e-signature:*

Video and Photography Consent

This section is for parents with students in grades 7-12 only. Parents, please read the following:

Child/Children's name(s)*

Please list the name(s) of children in grades 7-12.

Please select an option:*

You may not use any images, video, or audio of my child in any online, social media, or print format for any reason.

I consent that photographs/video recordings/audio recordings of my child may be used in the following circumstances:

Please check the box for each option that is permissible.

Posted within a private, closed Facebook group moderated by the sponsoring parish ministry/event

Posted on a public Facebook page moderated by the parish

Posted on a public webpage or website moderated by the parish or sponsoring ministry/event

Posted in the print or online version of the parish bulletin and Youth Ministry Newsletter

Posted on other digital or print promotional materials or publications affiliated with parish or sponsoring ministry

This form allows you, the parent or guardian, to identify how images of your child may or may not be used for purposes of print, online or social media communication or promotion. In any print, digital and online postings, your child will never be identified by written caption without specific written consent of the parent. Your child will never be “tagged” in any posting through social media.

Video and Photography Consent*

I have read the section above and understand it.

Verify the above by typing your (parent or guardian) name here to serve as your e-signature:*

PSR Fees

Price

Please select the number of students you are registering. 1 Student – $15.00; 2 Students – $25.00; 3 or more Students – $30.00

1 Student

2 Students

3 or more Students

Total

CAPTCHA

You may click below to pay PSR fees online; if you do not wish to pay online, click the button below and skip the payment page -you can place a check – made out to “Holy Rosary Religious Education” or cash in an envelope marked “PSR Fees” in the basket at church or mail to:

Holy Rosary Church
Attn: Donna Long
405 S. Main St.
Monroe City, MO 63456

Payment Method*

I would like to pay online

I would like to pay with cash or check by following the instructions above

This field is for validation purposes and should be left unchanged.

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← August 1, 2021

RCIA to Begin! →

573-735-4718 | 405 S. Main Street, Monroe City MO 63456
holyrosary.diojeffcity.org

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PSR Online Registration Open

Holy Rosary & St. Stephen PSR Registration

Parent/Guardian Information

Safe Environment Compliance

Emergency Contact Information

Student Section

Student #1

Student #2

Student #3

Student #4

Student #5

Student #6

Consent for Direct Communication with Minors

Social Media used by Holy Rosary and St. Stephen PSR/Youth Ministry

Facebook:

@HolyRosaryMC @HRSSYouthMinistry @HRSSFaithFormation

Instagram:

hr_ssfaithformation

Websites:

www.holyrosary.diojeffcity.org www.ststephenic.diojeffcity.org

Video and Photography Consent

PSR Fees