2024 Faith Formation Elementary Registration

2024 Faith Formation Elementary Registration

Church of The Holy Spirit
Classes begin Wednesday September 25th 6:15 pm- 7:30 pm

First Class will be a FAMILY EVENT
How many children are you signing up for Faith Formation *if signing up more than 4 children please visit our offices

1 Child2 Children3 Children4 Children
Student Information
Student #1: Name

First NameLast Name
Birth Date

MonthDayYear
Is child Baptized Catholic?
Where was your child Baptized/Date of Baptism?
Catechism Grade
Gender

MaleFemale
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student #2: Name

First NameLast Name
Birth Date

MonthDayYear
Is child Baptized Catholic?
Where was your child Baptized/Date of Baptism?
Catechism Grade
Gender

MaleFemale
If address is the same click here and skip next section

Yes
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student #3: Name

First NameLast Name
Birth Date

MonthDayYear
Is child Baptized Catholic?
Where was your child Baptized/Date of Baptism?
Catechism Grade
Gender

MaleFemale
If address is the same click here and skip next section

Yes
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student #4: Name

First NameLast Name
Birth Date

MonthDayYear
Is child Baptized Catholic?
Where was your child Baptized/Date of Baptism?
Catechism Grade
Gender

MaleFemale
If address is the same click here and skip next section

Yes
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Information
Name

First NameLast Name
Home Number
Cell Number
E-mail
example@example.com
Our primary communication mode will be through email so be sure to use your most up to date/ checked email address.
Emergency Information
Emergency Contact's Name

First NameLast Name
Relationship
Phone Number
Alt. Phone Number
Does the student have any allergies, chronic illness, special need, or medical conditions? If yes, please describe.
Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by {Organization} during the selected classes. In exchange for the acceptance of said child’s candidacy by Church of the Holy Spirit, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Church of the Holy Spirit. and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected class sessions.

In case of injury to said child, I hereby waive all claims against Church of the Holy Spirit. There is a risk of being injured that is inherent in all activities.
Medical Release and Authorization

As Parent and/or Guardian of the named student, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.

Release authorized on the dates and/or duration of the registered class.

This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of the named minor child, in my absence.

Classes*

1st-5th Grade Registration

$75.00

2nd GradeSacramental Year

$100.00

Additional Child

$25.00 Quantity

Total

$0.00

Credit Card

Date

MonthDayYear
Date
Should be Empty:

2024 Faith Formation Elementary Registration

Classes begin Wednesday September 25th 6:15 pm- 7:30 pm

Student Information

Our primary communication mode will be through email so be sure to use your most up to date/ checked email address.

Credit Card