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New Student Faith Formation Registration Form
New Student Faith Formation Registration Form
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This field is for validation purposes and should be left unchanged.
Family Last Name
(Required)
Primary Phone
(Required)
Father's Name
(Required)
First
Last
Father's Phone
(Required)
Father's Email
(Required)
Enter Email
Confirm Email
Mother's Name
(Required)
First
Last
Maiden Name
(Required)
Mother's Phone
(Required)
Address
(Required)
Street Address
Address Line 2
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Emergency Contact
Person(s) authorized to pick up my child at Religious Ed classes, in the event that I can’t be there at dismissal time.
Emergency Contact Name
(Required)
First
Last
Relation to Child
(Required)
Emergency Contact's Phone
(Required)
Emergency Contact Name
(Required)
First
Last
Relation to Child
(Required)
Emergency Contact's Phone
(Required)
Child(ren) Information
All Children must be signed in and signed out by their Parents or Authorized Persons in the grade appropriate sign-in book in the classrooms. If your child is eligible to receive Sacraments this year, you must complete a “REGISTRATION FOR SACRAMENTAL PREPARATION” form, in addition to this Registration Form. Sacramental Preparation is separate from Religious Education. Please have a copy of all Sacramental Certificates with the Church Seal.
Number of Children being registered:
1
2
3
4
5
Child 1 Information
Child's Name
(Required)
First
Last
Date of Birth
(Required)
MM slash DD slash YYYY
Place of Birth
(Required)
Current School Grade Level
(Required)
Religious Education Day
(Required)
Wednesday
Saturday
Sunday
FF Grade
(Required)
Baptism Date
MM slash DD slash YYYY
Church
1st Eucharist Date
MM slash DD slash YYYY
Church
Insurance Carrier
Policy/ Group Number
(Required)
Student's Physician
(Required)
First
Last
Physician's Phone
(Required)
Allergies
Other Medical Concerns
(Required)
Add another child?
(Required)
Yes
No
Child 2 Information
Child's Name
(Required)
First
Last
Date of Birth
(Required)
MM slash DD slash YYYY
Place of Birth
(Required)
Current School Grade Level
(Required)
Religious Education Day
(Required)
Wednesday
Saturday
Sunday
FF Grade
(Required)
Baptism Date
MM slash DD slash YYYY
Church
1st Eucharist Date
MM slash DD slash YYYY
Church
Insurance Carrier
Policy/ Group Number
(Required)
Student's Physician
(Required)
First
Last
Physician's Phone
(Required)
Allergies
Other Medical Concerns
(Required)
Add another child?
(Required)
Yes
No
Child 3 Information
Child's Name
(Required)
First
Last
Date of Birth
(Required)
MM slash DD slash YYYY
Place of Birth
(Required)
Current School Grade Level
(Required)
Religious Education Day
(Required)
Wednesday
Saturday
Sunday
FF Grade
(Required)
Baptism Date
MM slash DD slash YYYY
Church
1st Eucharist Date
MM slash DD slash YYYY
Church
Insurance Carrier
Policy/ Group Number
(Required)
Student's Physician
(Required)
First
Last
Physician's Phone
(Required)
Allergies
Other Medical Concerns
(Required)
Add another child?
(Required)
Yes
No
Child 4 Information
Child's Name
(Required)
First
Last
Date of Birth
(Required)
MM slash DD slash YYYY
Place of Birth
(Required)
Current School Grade Level
(Required)
Religious Education Day
(Required)
Wednesday
Saturday
Sunday
FF Grade
(Required)
Baptism Date
MM slash DD slash YYYY
Church
1st Eucharist Date
MM slash DD slash YYYY
Church
Insurance Carrier
Policy/ Group Number
(Required)
Student's Physician
(Required)
First
Last
Physician's Phone
(Required)
Allergies
Other Medical Concerns
(Required)
Add another child?
(Required)
Yes
No
Child 5 Information
Child's Name
(Required)
First
Last
Date of Birth
(Required)
MM slash DD slash YYYY
Place of Birth
(Required)
Current School Grade Level
(Required)
Religious Education Day
(Required)
Wednesday
Saturday
Sunday
FF Grade
(Required)
Baptism Date
MM slash DD slash YYYY
Church
1st Eucharist Date
MM slash DD slash YYYY
Church
Insurance Carrier
Policy/ Group Number
(Required)
Student's Physician
(Required)
First
Last
Physician's Phone
(Required)
Allergies
Other Medical Concerns
(Required)
