Child's Full Name Grade (Sept. 2021) School
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
Please fill this out if registering for the first time here at St. Mary's, if preparing for First Communion or Confirmation, or if info has changed.
Date Church Location
Child's Birth Date City & State of Birth
Father's Full Name Religion
Mother's Full Name (Maiden) Religion
EMERGENCY CONTACT (in case parents are unavailable) Name Relationship Phone
Are you interested in becoming a Catechist/Substitute Catechist for our program? ---YesNo
I would be willing to serve as a Gatekeeper at one or more sessions. ---YesNo
I give permission to the staff and volunteers of the Faith Formation Program to take photos of my child to be used in the Church Bulletin, Youth Ministry Newsletter, and in any way deemed appropriate: ---YesNo
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