2025-2026 Disciple Maker Formation Registration Primary Household Information
Household Last Name
Father
Father Phone Number
Mother
Mother Phone Number
Primary Email
Secondary Email
Street Address
City
Zip
Parish Membership (Parish membership will be confirmed with current rosters of all three cluster parishes. Non-members will be charged a $100 non-member fee. For more information on becoming a cluster parish member, please email Kaylyn at formation@stpeterslinger.org)
If other, please list (a $100 non-member fee applies for non-cluster members):
School District
Secondary Household Information
Parent/Guardian(s) Name(s)
Relationship to Child(ren)
Primary Phone Number
Secondary Phone Number
Primary Email
Secondary Email
Street Address
City
Zip
Student Information
Student 1 Name (First and Last)
Date of Birth (MM/DD/YY)
Gender
Please list educational, health, or physical needs your child may have so that we can better serve your child. For example, allergies, asthma, dietary restrictions, learning or behavioral needs, IEP, etc.
Educational, Health or Physical Needs
Grade in 2025-2026 School Year
Class Selection
Student 2 Name (First and Last)
Date of Birth (MM/DD/YY)
Gender
Please list educational, health, or physical needs your child may have so that we can better serve your child. For example, allergies, asthma, dietary restrictions, learning or behavioral needs, IEP, etc.
Educational, Health or Physical Needs
Grade in 2025-2026 School Year
Class Selection
Student 3 Name (First and Last)
Date of Birth (MM/DD/YY)
Gender
Please list educational, health, or physical needs your child may have so that we can better serve your child. For example, allergies, asthma, dietary restrictions, learning or behavioral needs, IEP, etc.
Educational, Health or Physical Needs
Grade in 2024-2025 School Year
Class Selection
Student 4 Name (First and Last)
Date of Birth (MM/DD/YY)
Gender
Please list educational, health, or physical needs your child may have so that we can better serve your child. For example, allergies, asthma, dietary restrictions, learning or behavioral needs, IEP, etc.
Educational, Health or Physical Needs
Grade in 2025-2026 School Year
Class Selection
Student 5 Name (First and Last)
Date of Birth (MM/DD/YY)
Gender
Please list educational, health, or physical needs your child may have so that we can better serve your child. For example, allergies, asthma, dietary restrictions, learning or behavioral needs, IEP, etc.
Educational, Health or Physical Needs
Grade in 2025-2026 School Year
Class Selection
Emergency Contact Information
Non-Parent Emergency Contact Name
Relationship to Child(ren)
Emergency Contact Phone Number
2025-2026 Disciple Maker Formation Fees 2025-2026 Formation fees are listed in the chart at the top of the registration form, on the Parent Resources page of the St. Peter website, and will be on the "Thank You For Registering" page after submitting this form. A fee calculator is also available on the Parent Resources page and the page after submitting this form. Please reach out to Kaylyn at formation@stpeterslinger.org with questions.
Payment Plans
Payment Plan
All information provided above is truthful to the best of my knowledge.
Electronic Signature (Please Type Full Name Below)
