Faith Formation Registration Form

Faith Formation Registration Form

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Donation towards Faith Formation - Financial aid available

CCD $40 per familyFirst Reconciliation / First Communion $20Confirmation $20
VERY IMPORTANT!!

Please be sure to send in a copy of all sacramental records for your child's file.

This includes record of Baptism and First Communion.
Parish:

Assumption ParishSt. Joseph CalasanctiusSt. PatrickOur Lady of Victory
Child's Name*

First NameLast Name
School and grade*
Date of Birth*

MonthDayYear
Date
Phone Number*
Please enter a valid phone number.
Sacramental Preparation

First ReconciliationFirst CommunionFirst Year Confirmation PreparationSecond Year Confirmation PreparationRCIA
Parent/Guardian Name

First NameLast Name
Parent/Guardian Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact Name*

First NameLast Name
Relationship
Phone Number*
Please enter a valid phone number.
Preferred Medical Facility
Name of Physician/Pediatrician

First NameLast Name
Phone Number
Please enter a valid phone number.
Any Allergies or Medical Conditions?*

YesNo
Does your child carry an epi-pen? (please note: if yes, it is the responsibility of the child's guardian to ensure the child has the epi-pen at every drop off and pick up)*

YesNo
Please give details
Parental Agreement I, the parent/guardian of Vacation bible school participant, who is less than nineteen years of age, grant permission for my daughter/son to participate in VACATION BIBLE SCHOOL AT ASSUMPTION PARISH IN GENEVA OHIO . By allowing my child to participate in the said program, I hereby assume all risk of accident or harm arising or growing out of, directly or indirectly, any incident of any kind occurring during the course of such program to my child and do hereby release and discharge the Bishop of the Diocese of Youngstown, and ASSUMPTION parish/school, and the agents, associates, and employees of the Bishop and parish/school who have organized or participated in the supervision of such program from all claims, demands, suits, causes or actions, rights, costs, expenses, and any compensations whatsoever which may occur to my family and its members during or resulting from participating in the program mentioned. *
Parent Initials
Do you want to add something about your child?
I, undersigned, agree with the following statements:*

I am the parent/guardian of the child indicated above.If emergency medical care is needed and I am unavailable, I authorize the supervising teacher to seek medical treatment for my child.I am giving my permission to take my child's pictures for classroom projects and post them on the church social Media site.
Date

MonthDayYear
Date
Signature*

Clear
Should be Empty: