Children's Ministry Registration 2021-2022

Divine Mercy Parish
Registration for Pre-Kindergarten through 8th Grade
 
If you have questions about this registration,
please contact Kelly Shoup at kshoup@divinemercynorthshore.org or by calling our office at 847-446-0856 x106.
 
*indicates required field

Registration Type

Is your family new or returning to Divine Mercy Children's Ministry? (You are considered a returning family if you were registered at Divine Mercy Children's Ministry in 2020-2021 or at Sacred Heart or St. Philip the Apostle Religious Education program in 2019-2020) *

Primary Family Contact Information

Father's Information

Is address information same as the primary family information above? *

Mother's Information

Is address information same as the primary family information above? *

Other Family Details

Children live with: *
 
If divorced, who has custody rights?
 

Child Information

Child One
It is important that we know about any special needs or other circumstances that pertain to your child. Thank you for sharing this confidential information.
Special Needs
My child has an IEP or 504 plan on record.

Child Two
It is important that we know about any special needs or other circumstances that pertain to your child. Thank you for sharing this confidential information.
Special Needs
My child has an IEP or 504 plan on record.

Child Three
It is important that we know about any special needs or other circumstances that pertain to your child. Thank you for sharing this confidential information.
Special Needs
My child has an IEP or 504 plan on record.

Child Four
It is important that we know about any special needs or other circumstances that pertain to your child. Thank you for sharing this confidential information.
Special Needs
My child has an IEP or 504 plan on record.
My child carries an epipen and will bring it to sessions.

Tuition and Fees

Tuition and fees are expected to be paid in full at the time of registration. 
If you choose to pay by check, please bring or send it to our office (1077 Tower Road, Winnetka, 60093) within 1 week of registration. 
 
Payment plans and scholarships are available
Please contact Kathy Handelman, our Children's Ministry Coordinator,
for information on payment plans and scholarships.
Please select your payment option: *
2021-2022 Tuition and Fees * Check all that apply. *
Sacramental Offering
* Please enter the quantity (number of students)
Current Total. Please click the "Calculate" button below for your total tuition due.  You will see this amount again on the checkout pages.
$0.00

Emergency Information/Authorization for Medical Treatment/Special Needs/Photo Release Affidavit

In the event that the undersigned, or my (our), physician cannot be reached, and in the judgment of the Coordinator of Children's Ministry or other authorized staff members, there is necessity for immediate examination and/or treatment of my (our) children(ren), I hereby authorize any of the aforesaid personnel to obtain for my (our) child(ren) such medical services.
0/255 characters
Emergency Contact - In case of emergency and parent(s) cannot be reached at the phone numbers provided to the Office of Religious Education, the following may be called.

Volunteer Service

We ask each family to contribute their time and talent to our program. Please indicate below how you will help.
I would like to volunteer as (check all that apply) *
Please submit your registration by clicking the "Submit" button below.  
You will be re-directed to our checkout page.
 
If you have questions about this registration,
please contact our Children's Ministry Office at childrensministry@divinemercynorthshore.org,
or Kelly Shoup at kshoup@divinemercynorthshore.org or call 847-446-0856 x106.
 
Thank you!