2022- 2023 Faith Formation Registration

2022-2023 St. Mary’s Faith Formation Registration

Please complete St. Mary’s Faith Formation Registration form to sign up your children or family for our Faith Formation and/or Family Faith Formation Program.
Parent/Guardian Information
Full Name of Father   First Name   Last Name
Phone Number of Father   Area Code   Phone Number
E-mail Address of Father   Email
Address of Father   Street Address   Address Line 2   City   State   Zip

Full Name of Mother  First Name   Last Name
Phone Number of Mother    Area Code   Phone Number
E-mail Address of Mother   Email
Address of Mother  Street Address   Address Line 2   City   State   Zip
Emergency Contact Information

In the event of an emergency, and neither Parent/Guardian is available, please provide St. Mary’s with an alternate contact.
Name of Emergency Contact   First Name   Last Name
Phone Number of Emergency Contact   Area Code   Phone Number
Relationship to Student/Students   Type a label
Email (Our primary form of communication is email. Please provide the address you check most often.)
example@example.com
Wednesday Night - Family Faith Formation Program

YesNo
If yes, please provide the grade level of student(s) attending
Faith Formation Program

YesNo
Student Information
Student(s) live(s) with… (place a check mark next to the statement that applies)

Both ParentsMotherFatherGuardian (other than Parent)
If student (s) live with Guardian (other than parent), please identify below the name, phone number, e-mail address, and address of Guardian.
Full Name of Guardian First Name   Last Name
Phone Number of Guardian   Area Code   Phone Number
E-mail Address of Guardian   Email
Address of Guardian   Street Address   Address Line 2   City   State   Zip

Student Information If not applicable, please write “N/A.”

	First Name	Last Name	Date of Birth	Gender (M/F)	Grade in Fall 2022	Date/Place of Baptism	Date/Place of First Communion	Allergies or Medical Issues (Y/N)	Special Needs (Y/N)
Student 1
Student 2
Student 3
Student 4

Please provide additional information of any allergies or medical issues:
Please provide additional information of any special needs or accommodations:
Release Statement

Please Sign Below If you Agree to the Following Statement:
“I give St. Mary’s Church permission to take and use photographs for any legal use, including but not limited to: publicity, copyright purposes, illustration, advertising, and web content. Furthermore, I understand that no royalty, fee, or other compensation shall become payable to me by reason of such use.”
Signature

Clear
Printed Name
Date Type a label
Follow this link for a One Time Payment to our Faith Formation program! In the notes, please include Faith Formation and your Family's Last Name.
Payment

The cost for Faith Formation is $60 per student in grades 5 through 12, with a maximum of $150 per family. For students in grades 5 through 12 who are not registered with the parish, the cost is $120 per student. For students in the Sacramental year of grade 10 (Confirmation), the cost is $80. There is no cost for Faith Formation for students in pre-K (age 4) through grade 4, with the exception of those participating in the Sacramental year of grade 2 (First Reconciliation and First Eucharist), the fee is $80. The fee for our Family Faith Formation program is $75. Please Mail Checks (made payable to St. Mary’s Faith Formation) or Cash to: St. Mary’s Faith Formation, 62 Warren Street, Glens Falls, NY 12801.
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2022-2023 St. Mary’s Faith Formation Registration

Parent/Guardian Information

Emergency Contact Information

Student Information

Release Statement

Payment