Spring 2026 Family Registration Form

Family Registration Form
Welcome to Agnus Dei Homeschool Cooperative!

Our teachers are excited to offer your family this opportunity of educational courses for your children! The first step is to register your family with Agnus Dei. Once your family is registered, you will be able to register your children for classes (using a separate form).

Please complete all pages of this online form to register your family. No payment is due now.

Agnus Dei Homeschool Cooperative is a Catholic learning center. We believe that the One, Holy, Catholic, and Apostolic Church is the one, true Church founded by our Lord Jesus Christ as the means of salvation for all mankind.

We believe that the Pope is the Vicar of Christ on earth. We embrace his rightful authority, and are in union with him and the Magisterium.

We believe in the protection of life from conception to natural death, and we uphold and defend the family as the domestic church.

As a Catholic cooperative, you can expect that:
- All of our teachers will be practicing Catholics
- The co-op will follow all of the teachings and magisterium of the Roman Catholic Church
- Classes will be taught within the context of the Catholic faith
- Teachers will pray with the students (this may include learning the rosary and other Catholic prayers)
- We will discuss and honor our Catholic saints

Family Last Name*

Parent #1 Name*

First NameLast Name

Parent #2 Name (Leave blank if not applicable)

First NameLast Name

Home address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Primary email address*
example@example.com

Phone Number*

Area CodePhone Number

Can this phone number receive texts?*

YesNo

Religion*
Parish Name

Student #1 Name*

First NameLast Name
Student #1 Grade*
Please use the grade that you use for homeschool reporting.
Student #2 Name

First NameLast Name
Student #2 Grade
Please use the grade that you use for homeschool reporting.
Student #3 Name

First NameLast Name
Student #3 Grade
Please use the grade that you use for homeschool reporting.
Student #4 Name

First NameLast Name
Student #4 Grade
Please use the grade that you use for homeschool reporting.
Student #5 Name

First NameLast Name
Student #5 Grade
Please use the grade that you use for homeschool reporting.
Student #6 Name

First NameLast Name
Student #6 Grade
Please use the grade that you use for homeschool reporting.
Student #7 Name

First NameLast Name
Student #7 Grade
Please use the grade that you use for homeschool reporting.
Student #8 Name

First NameLast Name
Student #8 Grade
Please use the grade that you use for homeschool reporting.
Student #9 Name

First NameLast Name
Student #9 Grade
Please use the grade that you use for homeschool reporting.
Student #10 Name

First NameLast Name
Student #10 Grade
Please use the grade that you use for homeschool reporting.

LIABILITY CONTROL VOLUNTARY RELEASE FORM -
Assumption of Risk and Indemnity Agreement

Parish: St Bernard's RC Church, Youngstown, NY

Activity: Agnus Dei Homeschool Cooperative

The undersigned person requests and is granted permission to participate in the above activity.

In consideration of the participation in the above activity, each of the undersigned, their personal representatives, heirs and assigns, DO HEREBY:
1) RELEASE, DISCHARGE AND COVENANT NOT TO SUE the above named parish and the Diocese of Buffalo for any and all claims and liabiity arising out of strict liability or ordinary negligence of release which causes the undersigned injury, death or property damage and further agrees to indemnify, defend and hold harmless releasee from any claim, judgment or expenses releasee may occur by participation in the described activity.
2) UNDERSTAND that participation in the described activity may involve risk of injury. The inherent danger is understood and voluntarily assumed.
3) ACKNOWLEDGE that no oral representations or inducements have been made to obtain signatures on this agreement. If any portion of this agreement is held invalid, it is agreed that the balance thereof shall continue in full legal force and effect.

I HAVE READ THIS DOCUMENT. I UNDERSTAND IT IS A RELEASE OF ALL CLAIMS. I UNDERSTAND I ASSUME ALL RISK INHERENT IN THIS ACTIVITY. I VOLUNTARILY SIGN MY NAME EVIDENCING MY ACCEPTANCE OF THESE PROVISIONS.
Signature*

Clear

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