Family Faith Formation Registration 2020- 2021

Mary Our Queen Roman Catholic Church

Family Faith Formation Registration Form 2020-2021
All participants must be registered members of Mary Our Queen Parish

Tuition:

Elementary - Middle School - High School

$100.00 per student for 1st two students

$250.00 family max

(if paid by 8/15/2020 25% discount applies, $75.00 each for first two students, family max of $187.50)

Confirmation (10th grade)

$250.00 includes registration fee and retreat fee

(if paid by 8/15/2020 a 25% discount applies to registration fee making cost $225.00)

* any family having difficulty to pay registration fee should contact Barb Garvin in the Faith Formation office at 770 863-8150.
Section A Session Choice
In following the Archdiocese of Atlanta guidelines and Covid restrictions, we will only be able to offer at home family faith formation at this time. Should the situation change, we will adjust our offerings.

Explanation of each model can be found on the Mary Our Queen web site under Faith Formation.
Family Table - at home family faith formation

Yes
Should our current situation change would you like to participant in the Hybrid model of Faith Formation? Your family would meet twice a month in person at church and contiue Family Table the other two weeks.

If so, please mark the sections below:
Hybrid Family Table

First and Third Sunday Second and Fourth Sunday
If you choose the Hybrid option, will one or two parents participate

one two
If you choose the Hybrid family option would you be willing to be a Catechist?

yes no
Assumption of the Risk relating to Covid -19

The Assumption of Risk wavier must be signed for each minor.
The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person to person through respiratory droplets when an infected individual coughs, sneezes or speaks. As a result, government agencies at all levels and federal, state and local health agencies recommend social distancing and have placed limits on the congregation of groups of individuals.

Mary Our Queen has put preventative measures in place to reduce the spread of COVID-19; however, the parish cannot guarantee that you or your child(ren) will not become infected with COVID-19. Further, attending activities on the campus of Mary Our Queen could increase your risk and that of your children for contracting COVID-19.

While Mary Our Queen will make all reasonable efforts to lower the risk of COVID-19 exposure and spread at the parish, the parish is unable to provide any guarantee that students or their families will not be exposed to or infected by COVID-19.

By enrolling your child(ren) in and attending parish faith formation, you acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that you, your child(ren) and or other family members may be exposed to or infected by COVID-19. It is expected that students and other family members will follow the preventative measures and guidelines implemented by Mary Our Queen including not coming to the parish premises if demonstrating any signs or symptoms of COVID-19.
First child's name

First Name Last Name
Signature of parent or guardian

Clear
Second child's name

First Name Last Name
Parent or guardian signature

Clear
Third child's name

First Name Last Name
Parent or guardian signature

Clear
Section A - Family Information
Family Name
Envelope #
Is your family registered at Mary Our Queen

Yes No
Emergency Phone Number

Area Code Phone Number
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Home Phone Number

Area Code Phone Number
Email - REQUIRED - Please keep updated.
example@example.com
Father's Name

First Name Last Name
Religion
Address if different

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Father's cell phone

Area Code Phone Number
Mother's Name

First Name Last Name
Religion
Mother's address if different

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Mother's Maiden Name

First Name Last Name
Mother's cell phone

Area Code Phone Number
Section C - Student information

There are 3 student registration blanks, please fill out one for each child you are registering. If more space is need, please fill out a second Family Faith Formation Form.
First Student name

First Name Last Name
Preferred name
Grade in fall of 2020
Date of Birth
Age as of 9/1/2020
Student Cell Phone (middle and high school students only)

Area Code Phone Number
Student Email (middle and high school only)
example@example.com
Gender

Male Female
Registration Status

New Returning Student
School your student will attend in 2020-2021
Allergies
Health Concerns
Has your child been Baptized ?

Yes No
Is Baptism Roman Catholic ?

yes No
Parish of Baptism
If not Roman Catholic, what denomination ?
Has your child received Reconciliation ?

yes No
Has your child received First Communion ?

Yes No
Has your child received Confirmation ?

Yes No
2nd Student Name

First Name Last Name
Preferred Name
Grade in Fall of 2020
Date of Birth
Age as of 9/1/2020
Student cell phone (middle and high school students only)

Area Code Phone Number
Student email (middle and high school students only)
example@example.com
Gender

Male Female
School student will attend in 2020-2021
Allergies
Health Concerns
Has your child been Baptized?

Yes No
Is Baptism Roman Catholic?

Yes No
Parish of Baptism
If not Roman Catholic, what denomination?
Type a question
Has your child received Reconciliation

Yes No
Has your child received First Communion?

Yes No
Has your child received Confirmation

Yes No
3rd Student Name

First Name Last Name
Preferred name
Grade in fall of 2020
Date of Birth
Age as of 9/1/2020
Student cell (middle and high school only)

Area Code Phone Number
Student email (middle and high school only
example@example.com
Gender
School you student will attend in 2020-2021
Allergies
Health Concerns
Has your child been Baptized?

Yes No
Is Baptism Roman Catholic?

Yes No
Parish of Baptism
If not Roman Catholic, what denomination?
Has your child received Reconciliation?

Yes No
Has your child received First Communion?

Yes No
Has your child received Confirmation?

Yes No
Has your child received Reconciliation?

Yes No
Has your child received First Communion?

Yes No
Has your child received Confirmation?

Yes No
Section D - Permission to Contact Youth

This section must be complete for each child.
Permission To Contact Youth

Mary Our Queen follows the Archdiocese of Atlanta's Social Media policy and guidelines for the use of Social Networking Sites with Minors for contacting you via social media. We may also use text messages and emails to contact youth. Per this policy and guidelines, parents must be aware of how social media and electronic communications are being used. Parents must be told how to access the sites, and be given the opportunity to be copied on all material sent to their children.

After receiving written permission to communicate with young people, Archdiocesan, parish employees and volunteers should be encouraged to save copies of conversations whenever possible, especially those that concern the personal sharing of a teen or young adult. Please reference the Archdiocese policy and guidelines on the Archdiocesan web site for more information.
First Child's Name

First Name Last Name
Please indicate below whether Mary Our Queen has permission to contact your child:

I, hereby grant permission for Mary Our Queen to conact my child, (mentioned above) for internal or external communications for one year via social media, email or text. I understand I can request the same commuications provided to my child, and that it does not have to be via the same technology (for example, if children receive a reminder via Twitter, parents can recieve it in printed form or by an email list.) NO, I do not want my child contacted or communicated with in any way.
Parent of guardian signature

Clear
Second child's name

First Name Last Name
Please indicate below whether Mary Our Queen has permission to contact your child:

I, hereby grant permission for Mary Our Queen to conact my child, (mentioned above) for internal or external communications for one year via social media, email or text. I understand I can request the same commuications provided to my child, and that it does not have to be via the same technology (for example, if children receive a reminder via Twitter, parents can recieve it in printed form or by an email list.) NO, I do not want my child contacted or communicated with in any way.
Parent or guardian signature

Clear
Third child's name

First Name Last Name
Third child's name

First Name Last Name
Please indicate below whether Mary Our Queen has permission to contact your child:

I, hereby grant permission for Mary Our Queen to conact my child, (mentioned above) for internal or external communications for one year via social media, email or text. I understand I can request the same commuications provided to my child, and that it does not have to be via the same technology (for example, if children receive a reminder via Twitter, parents can recieve it in printed form or by an email list.) NO, I do not want my child contacted or communicated with in any way.
Parent or guardian signature

Clear
Second child's name

First Name Last Name
Section E - Payment
As parent / guardian, I understand that upon completing this registration form, I must complete my regsitration by paying the amount due for the total number of children I will be registering. If I am a volunteer as a Catechist or Assistant catechist, i will complete a volunteer form before applying the 30% discount to my registration fees, I undersatnd that my registration will not be complete until i have done so. Please indicate your method of payment below and then sign to acknowledge that you undersatnd these terms.
Payment method

I will process my payment online through www.maryourqueen.com I will submit a check made out to Mary Our Queen to the Faith Formation Office
Signature

Clear
Section F - Medical Release
Emergency Medical Treatment: In the event of an emergency, I hereby give permission to transport my child to a hospital for emergency medical attention. I wish to be advised prior to any further treatment by the doctor and hospital.
First Child's name

First Name Last Name
2nd Child's name

First Name Last Name
3rd Child's name

First Name Last Name
4th Child's name

First Name Last Name
If you can not be reached, emergency contact
Phone Number

Area Code Phone Number
Relationship to child
If you are unable to reach parent / guardian or the emergency contact person, I hereby grant permission for the doctor and hospital to exercise professional judgment in treating my child.
Medical / Hospital insurance carrier
Name on Policy
Relationship to participant
Policy Number
Group Number
Medication and dosage my child is taking
I hereby grant permission for non prescription medication to be given, if deemed appropriate. (Tylenol, Ibuprofen, etc.)

Yes No
Drug Allergies and Child's name
Other allergies and Child's name
Health Problems or Limitations we should be aware of with Child's name:
Signature

Clear
Date
Section G - Annual Media Release Form

The Annual Media Release must be signed for each child.
Our parish, Mary Our Queen, uses images, interviews, and videos of our children for a variety of internal and external communications. Our forms of internal and external communications include but are not limited to: print, such as newspapers, bulletins, and newsletters; photographs and digital images; film and videos; web posts, web pages, and image carousels; social networking platforms including but not limited to Facebook, Twitter, and Instagram.

We follow the Archdiocese of Atlanta’s Social Media Policy and Guidelines for the Use of Social Networking Sites with Minors. Please see this resource for more information.

Please indicate below whether our parish has permission to circulate interviews, images, and/or videos of your child for all parish events for one year by signing one of the two statements.
First child's name

First Name Last Name
Yes, I hereby grant permission for the following parish, Mary Our Queen, to use images and interviews of my child, for internal or external communications for one year. My child may be photographed and/or interviewed for The Georgia Bulletin, and other media outlets. I understand content may be reprinted in The Georgia Bulletin or other media for public dissemination, including but not limited to film; video; television; radio; newspapers such as The Atlanta Journal and Constitution; websites and online platforms; and social media networks including but not limited to Facebook, Twitter, and Instagram. I release and relieve the parish and/or school, and the Archdiocese of Atlanta, from any responsibility or liability for any claims arising from the publication or reproduction of any photographs or interview in any news or other media. I waive any and all right to inspect or approve the finished images, video, or printed matter that may be used in conjunction with any image or video, or to approve the eventual use for which it may be applied.I understand that photographs, videos, and/or interviews are being done with the knowledge and approval of the parish and/or school, and that a signed release form is required for every participating individual. NO , I do not want my child included in, nor my child's image used, in any internal or external communications.
Parent or guardian signature

Clear
Second child's name

First Name Last Name
Yes, I hereby grant permission for the following parish, Mary Our Queen, to use images and interviews of my child, for internal or external communications for one year. My child may be photographed and/or interviewed for The Georgia Bulletin, and other media outlets. I understand content may be reprinted in The Georgia Bulletin or other media for public dissemination, including but not limited to film; video; television; radio; newspapers such as The Atlanta Journal and Constitution; websites and online platforms; and social media networks including but not limited to Facebook, Twitter, and Instagram. I release and relieve the parish and/or school, and the Archdiocese of Atlanta, from any responsibility or liability for any claims arising from the publication or reproduction of any photographs or interview in any news or other media. I waive any and all right to inspect or approve the finished images, video, or printed matter that may be used in conjunction with any image or video, or to approve the eventual use for which it may be applied.I understand that photographs, videos, and/or interviews are being done with the knowledge and approval of the parish and/or school, and that a signed release form is required for every participating individual. NO , I do not want my child included in, nor my child's image used, in any internal or external communications.
Parent or guardians signature

Clear
Third child's name

First Name Last Name
Yes, I hereby grant permission for the following parish, Mary Our Queen, to use images and interviews of my child, for internal or external communications for one year. My child may be photographed and/or interviewed for The Georgia Bulletin, and other media outlets. I understand content may be reprinted in The Georgia Bulletin or other media for public dissemination, including but not limited to film; video; television; radio; newspapers such as The Atlanta Journal and Constitution; websites and online platforms; and social media networks including but not limited to Facebook, Twitter, and Instagram. I release and relieve the parish and/or school, and the Archdiocese of Atlanta, from any responsibility or liability for any claims arising from the publication or reproduction of any photographs or interview in any news or other media. I waive any and all right to inspect or approve the finished images, video, or printed matter that may be used in conjunction with any image or video, or to approve the eventual use for which it may be applied.I understand that photographs, videos, and/or interviews are being done with the knowledge and approval of the parish and/or school, and that a signed release form is required for every participating individual. NO , I do not want my child included in, nor my child's image used, in any internal or external communications.
Parent or guardian signature

Clear
Should be Empty:

Mary Our Queen Roman Catholic Church

Section A Session Choice

Assumption of the Risk relating to Covid -19

Section A - Family Information

Section C - Student information

Section D - Permission to Contact Youth

Section E - Payment

Section F - Medical Release

Section G - Annual Media Release Form