Home
About
About Our Church
Our History
Our Patron Saint
Parish Staff
Newcomers
Welcome
Parish Registration
Becoming Catholic
Returning Catholics
RCIA - Rite of Christian Initiation
How Do I
Sacraments
Become Catholic
Become a Baptism or Confirmation Sponsor
Schedule a Baptism
Request to be Married
Request Anointing of the Sick
Special Requests
Receive Holy Communion at Home
Request a Mass
Request a Special Intention Candle
Request a Baptism, Marriage, or Confirmation Certificate
Request to be Placed on the Prayer List
Registration
Register with Parish
Update Parish Registration
Ministries
Ministries
Arimatheans
Baptism Mentoring
Elizabeth Ministry
Extraordinary Ministers
Life in the Spirit
Marriage Mentoring Program
Mercy Service
Music Program and Choir
Sacristans
Schedules
Ministry Schedule
Sacraments
Anointing of the Sick
Baptism
Schedule a Baptism
Baptism Registration Form
Confirmation
Holy Communion
Holy Matrimony
Holy Orders
Reconciliation and Penance
Parish Life
Get Involved
Adoration Chapel
Bingo
Parish Library
Smart Money / Gift Card Program
That Man is You
Men's Retreat
Youth
Altar Servers
Special Educational/Religious Events
Boy Scouts / Cub Scouts
Catechism / CCD / Religious Education
St. Theresa Parish Preschool Religious Education Program
Parish Religious Education Program New Student Registration Levels 1-8
St. Theresa School
Outreach
Gospel of Life Team
Healing Mass
Sister Parish
Church Groups
Chaplet of Divine Mercy
Council of Catholic Women
Little Flower Club
Bulletins
|||
Saint Theresa Parish
1300 Bridge Street, New Cumberland PA 17070
(717) 774-5918
Search
Search
Home
About
About Our Church
Our History
Our Patron Saint
Parish Staff
Newcomers
Welcome
Parish Registration
Becoming Catholic
Returning Catholics
RCIA - Rite of Christian Initiation
How Do I
Sacraments
Become Catholic
Become a Baptism or Confirmation Sponsor
Schedule a Baptism
Request to be Married
Request Anointing of the Sick
Special Requests
Receive Holy Communion at Home
Request a Mass
Request a Special Intention Candle
Request a Baptism, Marriage, or Confirmation Certificate
Request to be Placed on the Prayer List
Registration
Register with Parish
Update Parish Registration
Ministries
Ministries
Arimatheans
Baptism Mentoring
Elizabeth Ministry
Extraordinary Ministers
Life in the Spirit
Marriage Mentoring Program
Mercy Service
Music Program and Choir
Sacristans
Schedules
Ministry Schedule
Sacraments
Anointing of the Sick
Baptism
Confirmation
Holy Communion
Holy Matrimony
Holy Orders
Reconciliation and Penance
Parish Life
Get Involved
Adoration Chapel
Bingo
Parish Library
Smart Money / Gift Card Program
That Man is You
Men's Retreat
Youth
Altar Servers
Special Educational/Religious Events
Boy Scouts / Cub Scouts
Catechism / CCD / Religious Education
St. Theresa School
Outreach
Gospel of Life Team
Healing Mass
Sister Parish
Church Groups
Chaplet of Divine Mercy
Council of Catholic Women
Little Flower Club
Bulletins
Parish Religious Education Program New Student Registration Levels 1-8
Parish Life
Get Involved
Adoration Chapel
Bingo
Parish Library
Smart Money / Gift Card Program
That Man is You
Men's Retreat
Youth
Altar Servers
Special Educational/Religious Events
Boy Scouts / Cub Scouts
Catechism / CCD / Religious Education
St. Theresa Parish Preschool Religious Education Program
Parish Religious Education Program New Student Registration Levels 1-8
St. Theresa School
Outreach
Gospel of Life Team
Healing Mass
Sister Parish
Church Groups
Chaplet of Divine Mercy
Council of Catholic Women
Little Flower Club
The maximum number of form submissions has been reached. This form is currently not available.
Automated Message
We utilize an automated phone and email messaging system for class cancellations, schedule changes, and important reminders. Please list the email address and phone number(s) you would like us to use for messages regarding cancellations and reminders.
.
Phone Number
REQUIRED
Please fill out this field.
Please enter a phone number.
Alternate Phone Number
Please enter a phone number.
Email
REQUIRED
Please fill out this field.
Please enter an email address.
Additional Email
Please enter an email address.
Due to current circumstances regarding Covid-19, our 2021-2022 program may continue virtually on Sunday evenings, but we prayerfully hope to meet again in-person.
For now, please place a mark beside the in-person program you prefer.
We will notify you with additional information as soon as we can.
Registering For
REQUIRED
Wednesday Evening Class
Sunday Family and Faith Program (1x month +homework)
Please fill out this field.
Family Home Parish
REQUIRED
Saint Theresa Parish
Other
Please fill out this field.
If Other, provide parish name:
Please enter valid data.
Name of Person Filling Out Form
REQUIRED
Please fill out this field.
Please enter valid data.
Family Name
REQUIRED
Please fill out this field.
Please enter valid data.
Phone Number
REQUIRED
Please fill out this field.
Please enter a phone number.
Family Address
REQUIRED
Please fill out this field.
Please enter valid data.
City
REQUIRED
Please fill out this field.
Please enter valid data.
State
REQUIRED
AK
AL
AR
AS
AZ
CA
CO
CT
DC
DE
FL
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MH
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
PW
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Please fill out this field.
Zip
REQUIRED
Please fill out this field.
Please enter a zip code.
Mother's Name
REQUIRED
Please fill out this field.
Please enter valid data.
Mother's Maiden Name
REQUIRED
Please fill out this field.
Please enter valid data.
Mother's Religious Affiliation
REQUIRED
Please fill out this field.
Please enter valid data.
Father's Name
REQUIRED
Please fill out this field.
Please enter valid data.
Father's Religious Affiliation
REQUIRED
Please fill out this field.
Please enter valid data.
Emergency Information
Please provide the following information in the event of an emergency. I authorize the staff of Saint Theresa to seek emergency medical care for my child as deemed appropriate
Emergency Contact Name
REQUIRED
Please fill out this field.
Please enter valid data.
Phone Number
REQUIRED
Please fill out this field.
Please enter a phone number.
Relationship
REQUIRED
Please fill out this field.
Please enter valid data.
Physician's Name
REQUIRED
Please fill out this field.
Please enter valid data.
Physician's Phone
REQUIRED
Please fill out this field.
Please enter valid data.
Hospital Preference
REQUIRED
Please fill out this field.
Please enter valid data.
Volunteer Opportunities
Our program is volunteer based. Please consider helping in one of the following areas:
Catechist (Teacher)
Substitute Catechist
Classroom Aide
Building Monitor (Wed evenings, about 1x month)
Comments/Concerns:
Please enter valid data.
In registering my child for Saint Theresa Religious Formation, I acknowledge that I have a responsibility, as the primary faith educator of my child, to support the teaching of religion and to assist my student's education by our family practice of prayer and good works, observing the Law of God and attending Mass each Sunday and Holy Day. I agree to abide by the policies in the parent handbook.
Signature (Indicate parent name as electronic signature)
REQUIRED
Please fill out this field.
Please enter valid data.
Date
REQUIRED
Please fill out this field.
Please enter a date.
2021-2022 REGISTRATION FEES
EARLY REGISTRATION
- by May 1, 2021 (discounted):
One Child - $50;
Two Children - $70;
Three Children - $85
REGULAR REGISTRATION
- by July 31, 2021:
One Child - $90;
Two Children - $110;
Three Children - $130
LATE REGISTRATION
- AFTER August 1, 2021 (includes a late fee):
One Child - $100;
Two Children - $125;
Three Children - $150.
Payment
REQUIRED
Cash
Check
Online Payment
Please fill out this field.
Check #
Please enter valid data.
Amount:
Please enter valid data.
Date
REQUIRED
Please fill out this field.
Please enter a date.
Payment by credit card can be made online by going to "Online Giving" on the parish home page (
www.saintheresaparish.org
). There you will be able to enter the amount due beside “Rel Education.”
Student Information. Complete information for each child.
Student Information is provided below for how many children??
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.
Age
REQUIRED
Please fill out this field.
Please enter valid data.
2021-2022 Grade
REQUIRED
Please fill out this field.
Please enter valid data.
School Attending
REQUIRED
Please fill out this field.
Please enter valid data.
Date of Birth
REQUIRED
Please fill out this field.
Please enter a date.
Church Baptized
REQUIRED
Please fill out this field.
Please enter valid data.
Date Baptized
REQUIRED
Please fill out this field.
Please enter a date.
If child received any prior formal religious education, please indicate where.
Please enter valid data.
Sacraments Received
Penance
Holy Communion
Confirmation
Please note any conditions, disorders, allergies, physical, senory, cognitive, ADHD, or social/emotional disabilities of which we should be aware
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.
Age
REQUIRED
Please fill out this field.
Please enter valid data.
2021-2022 Grade
REQUIRED
Please fill out this field.
Please enter valid data.
School Attending
REQUIRED
Please fill out this field.
Please enter valid data.
Date of Birth
REQUIRED
Please fill out this field.
Please enter a date.
Church Baptized
REQUIRED
Please fill out this field.
Please enter valid data.
Date Baptized
REQUIRED
Please fill out this field.
Please enter a date.
If child received any prior formal religious education, please indicate where.
Please enter valid data.
Sacraments Received
Penance
Holy Communion
Confirmation
Please note any conditions, disorders, allergies, physical, senory, cognitive, ADHD, or social/emotional disabilities of which we should be aware
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.
Age
REQUIRED
Please fill out this field.
Please enter valid data.
2021-2022 Grade
REQUIRED
Please fill out this field.
Please enter valid data.
School Attending
REQUIRED
Please fill out this field.
Please enter valid data.
Date of Birth
REQUIRED
Please fill out this field.
Please enter a date.
Church Baptized
REQUIRED
Please fill out this field.
Please enter valid data.
Date Baptized
REQUIRED
Please fill out this field.
Please enter a date.
If child received any prior formal religious education, please indicate where.
Please enter valid data.
Sacraments Received
Penance
Holy Communion
Confirmation
Please note any conditions, disorders, allergies, physical, senory, cognitive, ADHD, or social/emotional disabilities of which we should be aware
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.
Age
REQUIRED
Please fill out this field.
Please enter valid data.
2021-2022 Grade
REQUIRED
Please fill out this field.
Please enter valid data.
School Attending
REQUIRED
Please fill out this field.
Please enter valid data.
Date of Birth
REQUIRED
Please fill out this field.
Please enter a date.
Church Baptized
REQUIRED
Please fill out this field.
Please enter valid data.
Date Baptized
REQUIRED
Please fill out this field.
Please enter a date.
If child received any prior formal religious education, please indicate where.
Please enter valid data.
Sacraments Received
Penance
Holy Communion
Confirmation
Please note any conditions, disorders, allergies, physical, senory, cognitive, ADHD, or social/emotional disabilities of which we should be aware
Child 5
First Name
REQUIRED
Please fill out this field.
Please enter valid data.
Last Name
REQUIRED
Please fill out this field.
Please enter valid data.
Age
REQUIRED
Please fill out this field.
Please enter valid data.
2021-2022 Grade
REQUIRED
Please fill out this field.
Please enter valid data.
School Attending
REQUIRED
Please fill out this field.
Please enter valid data.
Date of Birth
REQUIRED
Please fill out this field.
Please enter a date.
Church Baptized
REQUIRED
Please fill out this field.
Please enter valid data.
Date Baptized
REQUIRED
Please fill out this field.
Please enter a date.
If child received any prior formal religious education, please indicate where.
Please enter valid data.
Sacraments Received
Penance
Holy Communion
Confirmation
Please note any conditions, disorders, allergies, physical, senory, cognitive, ADHD, or social/emotional disabilities of which we should be aware
Child 6
First Name
REQUIRED
Please fill out this field.
Please enter valid data.
Last Name
REQUIRED
Please fill out this field.
Please enter valid data.
Age
REQUIRED
Please fill out this field.
Please enter valid data.
2021-2022 Grade
REQUIRED
Please fill out this field.
Please enter valid data.
School Attending
REQUIRED
Please fill out this field.
Please enter valid data.
Date of Birth
REQUIRED
Please fill out this field.
Please enter a date.
Church Baptized
REQUIRED
Please fill out this field.
Please enter valid data.
Date Baptized
REQUIRED
Please fill out this field.
Please enter a date.
If child received any prior formal religious education, please indicate where.
Please enter valid data.
Sacraments Received
Penance
Holy Communion
Confirmation
Please note any conditions, disorders, allergies, physical, senory, cognitive, ADHD, or social/emotional disabilities of which we should be aware
Submit
This site is protected by reCAPTCHA and the Google
Privacy Policy
and
Terms of Service
apply.