FAITH FORMATION REGISTRATION FORM 2023-2024 English Form

St. Columba Faith Formation Registration Form
Parent/Family Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone:
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Cell Phone: (Primary)
Format: (000) 000-0000.
Cell Phone: (Secondary)
Format: (000) 000-0000.
Emergency Contact (Not Parents):
Name

First NameLast Name
Phone
Format: (000) 000-0000.
Student #1 Name

First NameLast Name
Date of Birth

MonthDayYear
Date
School
Grade
Allergies
Previous Faith Formation Year
Parish
YesNo
YesNo
BaptismReconciliationCommunionConfirmation
Date of Baptism

MonthDayYear
Date
Parish/ Church
Address
Copy of certificate included
Student #2 Name

First NameLast Name
Date of Birth

MonthDayYear
Date
School
Grade
Allergies
Previous Faith Formation Year
Parish
YesNo
YesNo
BaptismReconciliationCommunionConfirmation
Date of Baptism

MonthDayYear
Date
Parish/ Church
Address
Copy of certificate included
Student #3 Name

First NameLast Name
Date Of Birth

MonthDayYear
Date
School
Grade
Allergies
Previous Faith Formation Year
Parish
YesNo
YesNo
BaptismReconciliationCommunionConfirmation
Date of Baptism

MonthDayYear
Date
Parish/ Church
Address
Copy of certificate included
St. Columba Faith Formation Parental Consent/Medical Release Form
Children are not allowed to be admitted to classes/events unless a completed Parental Consent form and a Medical Release form are on file. I understand that I am required to read the policies and rules listed in the Handbook on the parish website. By enrolling the children of my family/guardianship in the St. Columba Catholic Church Faith Formation and Youth Ministry Programs for the 2023-2024 year, which is from September 2023 - April 2024 I consent to abide by the policies stated in the handbook. I understand that failure to comply with this policy could bring about disciplinary actions including, in extreme cases, dismissal of my child from the faith formation program. I understand that I am responsible for sharing the rules, regulations, and other valuable information in this handbook with my child. I permit my child to participate in all activities offered on St. Columba grounds during normal Faith Formation & Youth Ministry times throughout September 2023 - April 2024

As a parent and/or guardian, I do herewith authorize the treatment, by a qualified and license medical doctor, of the following minor(s) in the event of a medical emergency which, in the opinion of the attending physicians, may endanger his or her life, cause disfigurement, physical impairment or undue discomfort if delayed. This authority is granted only after a reasonable effort has been made to reach me. This release will be in effect from September 2023 - April 2024. This release form is completed and signed of my own free will with the sole purpose of authorizing medical treatment under emergency circumstances in my absence.
Parent or legal guardian signature*

Clear
Date

MonthDayYear
Date
Please initial the methods listed below that you approve for the use of images and pictures of your student that may be used at St. Columba according to the policies of the Archdiocese of Mobile.
Bulletin Boards
The Catholic Week
Facebook (closed group)
Church Bulletin
Parish Website
Instagram
Email
example@example.com
Registration Fees
Registration Fees Please make checks payable to St. Columba Church $25 per Student/Adult - Grades K5-12 An Additional $25 per Student registered for First Communion or Confirmation (Total of $50 per student in First Communion or Confirmation)

Cash/Check/Venmo

Are acceptable payment methods.

Venmo is @stcolumbadothan
(OFFICE USE ONLY)Ministry Acknowlegement:
CM
YM
HM
Should be Empty:

Registration Fees

(OFFICE USE ONLY)Ministry Acknowlegement: