Family Name Please enter valid data.

Street Address REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Are you registered members of Christ the King Parish? Yes No

If NO please indicate the name of your home parish. ***You will need a letter from your pastor of the parish at which you are registered to attend our program. Please enter valid data.

Please select the session your family woud like to attend: REQUIRED Sunday A Sunday B Please fill out this field.

Parent 1 First Name REQUIRED Please fill out this field. Please enter valid data.

Parent 1 Last Name REQUIRED Please fill out this field. Please enter valid data.

Parent 1 Email REQUIRED Please fill out this field. Please enter an email address.

Parent 1 Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Parent 2 First Name Please enter valid data.

Parent 2 Last Name Please enter valid data.

Parent 2 Email Please enter an email address.

Parent 2 Phone Number Please enter a phone number.

# of children being registered 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.
- Grade REQUIRED Please fill out this field.
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.
- Grade REQUIRED 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.
- Grade REQUIRED 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.
- Grade REQUIRED Please fill out this field.
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.
- Grade REQUIRED Please fill out this field.
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.
- Grade REQUIRED Please fill out this field.

PHOTOGRAPHIC RELEASE:

I hereby grant to the Diocese of Pittsburgh, Christ the King Parish, and their respective licenses, successors and assigns, the right and permission, with respect to those photographs taken of me/us or the minor(s) named above ,and with respect to any printed or electronic matter in connection therewith, to do the following:

1. To include such photographs on the Diocese of Pittsburgh and or Christ the King websites and on print material.

2. To use my/our names, or the name of the minor(s) on whose behalf I/we are signing, in connection with the foregoing. I hereby release, discharge and agree to indemnify and hold harmless the Diocese of Pittsburgh and or Christ the King Parish and their legal representatives, licenses, successor and assigns from all claims and demands whatsoever arising out of or in connection with the foregoing and waive any right to inspect or approve the same. I certify that I am the parent/guardian of the minor(s) under the age of eighteen years, and hereby consent of behalf of said minor(s) to the use of any of the photographs taken of said minor(s) pursuant to the terms set forth in this Photographic Release, including, without limitation, the release, discharge, and hold harmless provision thereof.

Please select one: REQUIRED Yes, I give permission for Christ the King Parish to use my image/my child's image. No, I DO NOT give permission for Christ the King Parish to use my image/my child's image. Please fill out this field.

Registration fees are $65 per child or $220 for a family of four or more children.

The registration fee can be paid online using either a credit card or checking account.

If you prefer to mail a check instead of paying online, please do not complete this registration. See instructions at the top of this page for downloading a paper registration form.

Registration fee amount: REQUIRED 70.0 – 1 child 140.0 – 2 children 210.0 – 3 children 240.0 – 4 or more children Please fill out this field.

Saint Edward Church 450 Walnut Street Blawnox, PA 15238 412-828-4066	Saint Joseph Church Administrative Center 342 Dorseyville Road Pittsburgh, PA 15215 412-963-8885	Madonna of Jerusalem Church 201 9th Street Sharpsburg, PA 15215 412-784-8700	Saint Mary Church 210 Garnier Street Sharpsburg, PA 15215 412-784-8700	Saint Scholastica Church 309 Brilliant Avenue Aspinwall, PA 15215 412-781-0186
		Contact Us

Option 1

PHOTOGRAPHIC RELEASE: