CFF Program Registration, Returning Student

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Children's Faith Formation

Registration Form

RETURNING STUDENT

2026-2027

St. John the Baptist Catholic Church, Dunnellon, FL
*COMPLETE ONE FORM FOR EACH REGISTERING STUDENT.
Please provide ALL information requested below before submitting your child's registration form. Thank you.
Student Information:
FAMILY NAME:
Surname
Child's Name

First NameLast Name
Age (as of September 2026)
Birth Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Place of Birth
City AND State/Province (or Country, if outside the US)
Gender - Please select
Grade (as of September 2026)
Grade
School Name (as of September 2026)
School's Name
Please type EXACTLY how you want your child's name to read on any programs/ certificates issued by the Children's Faith Formation Program.
Child's Name

Pickup Authorization
In an effort to protect our students, we ask that you let us know, in advance, who has your permission to pick up your child from Children's Faith Formation Classes.

Please list those individuals below:
Name

First NameLast Name
Phone Number

Area CodePhone Number
Relationship to Child or Family
Name

First NameLast Name
Phone Number

Area CodePhone Number
Relationship to Child or Family
Name

First NameLast Name
Phone Number

Area CodePhone Number
Relationship to Child or Family
Name

First NameLast Name
Phone Number

Area CodePhone Number
Relationship to Child or Family
The information above is correct, and I hereby give permission for my child to be picked up by the individual(s) listed above. I understand that my child will NOT be released to any individual that is not listed on this form.
Parent/Legal Guardian Signature
Printed Name
Please print/type your name

EMERGENCY INFORMATION
This information will be extremely important in the event of an accident or medical emergency.
Child's Medical Information:
Primary Doctor
Name of Doctor or Practice
Phone Number
Office Number
Insurance Plan
Insurance #
Contract Number
Group #
Policy Holder
Name of Subscriber
*In the case of an emergency, it is imperative that the Children's Faith Formation Office be able to reach the child's Parent/Legal Guardian.

When attempts are not successful, we will need a list of the names of individuals to whom we may contact and release your child if we cannot reach you.
Emergency Contact #1:
Name

First NameLast Name
Phone Number

Area CodePhone Number
Relationship to Child or Family
Emergency Contact #2:
Name

First NameLast Name
Phone Number

Area CodePhone Number
Relationship to Child or Family
Emergency Contact #3:
Name

First NameLast Name
Phone Number

Area CodePhone Number
Relationship to Child or Family
Please indicate ANY VITAL INFORMATION you think the Children's Faith Formation Office may need to know. This may include special needs (learning, physical, dietary, allergies, etc.) This information will be kept CONFIDENTIAL.
IF YOU NEED FURTHER ASSISTANCE, PLEASE CONTACT THE CHILDREN'S FAITH FORMATION OFFICE AT 352-489-3166, EXTENSION 14.
Parent/Legal Guardian Consent And Agreement for Emergencies

As Parent/Legal Guardian, I consent to have my child receive first aid by St. John the Baptist Catholic Church Staff/Catechists and, if necessary, be transported to receive emergency care. I will responsibile for all charges not covered by insurance. I consent that the emergency contact person(s) listed above is/are to be authorized contact with, release of emergency related information, and/or release of my child in the event of illness, evacuation, or other emergency that may occur while my child is attending Children's Faith Formation Classes. I further consent for this/these individual(s) to ACT ON MY BEHALF until I am available.
Parent/Legal Guardian Signature
Printed Name
Please print/type your name

Photo/Videotape Recording Authorization:
Please choose the options that apply to your child.
Additional comments: Use this space if you wish to specify details about your consent preferences (for example, if you authorize the bulletin, but not social media).
IF YOU NEED FURTHER ASSISTANCE, PLEASE CONTACT THE CHILDREN'S FAITH FORMATION OFFICE AT 352-489-3166, EXTENSION 14.
I hereby expressly assign to the Diocese of Orlando, and to all its agents all the rights, title and interest in, and to all photos/videotape recordings made by such in which my child appears and/or his/her voice is used in and in connection with the videotaping of this event. I hereby authorize the reproduction, sale, lease, copyright, exhibition, broadcast and/or any distribution of said photos/videotape without limitation for any purpose whatsoever; and I further waive all rights to any compensation for my child’s appearance or participation in the photographs/videotape recordings.
Parent/Legal Guardian Signature
Printed Name
Please print/type your name

CHILDREN'S FAITH FORMATION PROGRAM

2026-2027
My PREFERRED METHOD of communication to receive program news and updates is:
I desire that my child participate in the 2026-2027 Children's Faith Formation Program of St. John the Baptist Catholic Church, Dunnellon, Florida. To the best of my knowledge, the information that I have provided on this registration form is complete and correct.
Parent/Legal Guardian Signature
Printed Name
Please print/type your name
Relationship to child
If you selected "OTHER", please explain relationship to child
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
If you need assistance, please contact the Children's Faith Formation Office: 352-489-3166, extension 14.
Once you click SUBMIT, your child's registration will be sent. You will NOT be able to access or make further edits.
Should be Empty:

Student Information:

Current Family Residence Information:

*In the case of an emergency, it is imperative that the Children's Faith Formation Office be able to reach the child's Parent/Legal Guardian.

When attempts are not successful, we will need a list of the names of individuals to whom we may contact and release your child if we cannot reach you.

Emergency Contact #1:

Emergency Contact #2:

Emergency Contact #3: