Download & Print Form Grade 10 Faith Formation / Confirmation meets Sundays from 7:00pm-8:30pm.
Youth's Full Name Grade (Sept. 2018) School
Medical Conditions
Parent or Guardian to whom mail should be sent and with whom the child resides: Name Telephone (Home) Address Town ZIP Email
Work # (Husband) Work # (Wife)
In cases of divorce or separation, would you like duplicate info sent to both parents? ---YesNo
EMERGENCY CONTACT (in case parents are unavailable) Name Relationship Phone
If Youth wasn't Baptized nor celebrated 1st Communion here at St. Mary's, please fill this out and send a copy of the Baptismal Certificate
Baptism Date Church Location
1st Communion Date Church Location
Youth's Birth Date City & State of Birth
Father's Full Name Religion
Mother's Full Name Religion
Registration Fees: $40 for one youth, $70 for two youths, an additional $30 per youth for more than two. *For registrations after June 30, there is a late fee of $5 per child.
The Confirmation process also has special costs (Retreat) and meetings. More information will follow at a later date.
Registration and fee due by June 30. Please place fee (either with youth's name and "Confirmation Fee" if registering online, or in envelope with registration form) in Mass collection basket or mail to:
St. Mary's Church Office of Faith Formation 80 Mansion St. Coxsackie, NY 12051
I will pay the registration fee by June 30
I will be willing to help with car pools and special activities
I give my permission to the staff and volunteers of St. Mary's Faith Formation Program to take photos of my child which may be used in Church bulletins, newsletters, or in any other way deemed appropriate by St. Mary's Faith Formation Program. ---YesNo