Faith Formation Registration Form

Parent First Name(s) REQUIRED Please fill out this field. Please enter valid data.

FAMILY NAME REQUIRED Please fill out this field. Please enter valid data.

Home phone REQUIRED Please fill out this field. Please enter valid data.

PRIMARY CELL# REQUIRED Please fill out this field. Please enter valid data.

ALTERNATE CELL # Please enter valid data.

May we text information? REQUIRED Yes No Please fill out this field.

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.

Family Email REQUIRED Please fill out this field. Please enter valid data.

Register number of children REQUIRED Please fill out this field.
Child Name 1
- First and Last Name REQUIRED Please fill out this field. Please enter valid data.
Child Name 2
- First and Last Name REQUIRED Please fill out this field. Please enter valid data.
Child Name 3
- First and Last Name REQUIRED Please fill out this field. Please enter valid data.
Child Name 4
- First and Last Name REQUIRED Please fill out this field. Please enter valid data.

Date of Birth REQUIRED Please fill out this field.
Child 1
- REQUIRED Please fill out this field. Please enter a date.
Child 2
- REQUIRED Please fill out this field. Please enter a date.
Child 3
- REQUIRED Please fill out this field. Please enter a date.
Child 4
- REQUIRED Please fill out this field. Please enter a date.

Gender REQUIRED Please fill out this field.
Child 1
- Female Male Please fill out this field.
Child 2
- Female Male Please fill out this field.
Child 3
- Female Male Please fill out this field.
Child 4
- Female Male Please fill out this field.

Grade Entering REQUIRED Please fill out this field.
Child 1
- REQUIRED Please fill out this field. Please enter valid data.
Child 2
- REQUIRED Please fill out this field. Please enter valid data.
Child 3
- REQUIRED Please fill out this field. Please enter valid data.
Child 4
- REQUIRED Please fill out this field. Please enter valid data.

School Attending REQUIRED Please fill out this field.
Child 1
- REQUIRED Please fill out this field. Please enter valid data.
Child 2
- REQUIRED Please fill out this field. Please enter valid data.
Child 3
- REQUIRED Please fill out this field. Please enter valid data.
Child 4
- REQUIRED Please fill out this field. Please enter valid data.

Place of Baptism REQUIRED Please fill out this field.
Child 1
- REQUIRED Please fill out this field. Please enter valid data.
Child 2
- REQUIRED Please fill out this field. Please enter valid data.
Child 3
- REQUIRED Please fill out this field. Please enter valid data.
Child 4
- REQUIRED Please fill out this field. Please enter valid data.

Date of Baptism REQUIRED Please fill out this field.
Child 1
- REQUIRED Please fill out this field. Please enter a date.
Child 2
- REQUIRED Please fill out this field. Please enter a date.
Child 3
- REQUIRED Please fill out this field. Please enter a date.
Child 4
- REQUIRED Please fill out this field. Please enter a date.

Photo Release REQUIRED

PHOTO RELEASE: Do we have permission to display your child's name and/or images, video across all forms of communications? ie; website, newsletter, bulletin, collaborative facebook/instagram page or other.

No, I do not agree. Yes, I agree. The church has permission to display my child's name and/or images, video across all forms of communications? ie; website, newsletter, bulletin, collaborative Facebook/Instagram page or other. Please fill out this field.

In case of an emergency: name of person to call (other than Parents/Guardians) REQUIRED Please fill out this field. Please enter valid data.

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

Relationship to child REQUIRED Please fill out this field. Please enter valid data.

Registered in the Parish? REQUIRED Please fill out this field.

Are you registered in the parish? REQUIRED Yes, Holy Family Yes, St. Irene No Please fill out this field.