Language
English (US)
Spanish (Latin America)
Vietnamese
St. Alphonsus Faith Formation Registration 2024-25
We have faith formation offerings for all parishioners. Visit the Faith Formation webpage at stalphonsusfaithformation.weebly.com for details on the programs that will apply to you and your family. By filling out this form you will help our parish improve communications with you and your family.
Mother's Name
*
First Name
Maiden Name
Last Name
Mother's Email
*
example@example.com
Mother's Cell Phone Number
*
Father's Name
*
First Name
Last Name
Father's Email
*
example@example.com
Father's Cell Phone Number
*
Who does/do the child/children live with and what is their address?
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Preferred language - English? Spanish? Vietnamese? Other?
*
(optional) home landline phone
Emergency Contact
*
First Name
Last Name
Cell Phone Number
*
Does either parent want to talk to someone about receiving any Sacraments for themselves?
Baptism, First Communion, Confirmation, Sacramental Marriage (including blessing a civil marriage), RCIA
Back
Next
Childrens' Names and Information
Child #1
*
First Name
Last Name
Birthdate
*
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Please select a year
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Where was the child born (city, state, country)?
*
What grade in 2024-25? Infant/Toddler, Pre-K, Kindergarten, grade 1-12
*
Anything we should know about this child? Allergies/accommodations needed
*
Has he/she been baptized?
*
No
Yes, at St. Alphonsus
Yes, at another Catholic Church
Yes, in another christian denomination
If baptized other than St. Alphonsus, please name the CHURCH and LOCATION (city, state, country).
*
Has he/she received the Sacrament of First Communion?
*
Yes
No
Has he/she received the Sacrament of Confirmation?
*
Yes
No
Child #2
First Name
Last Name
Birthdate
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Please select a year
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Where was the child born (city, state, country)?
What grade in 2024-25? Infant/Toddler, Pre-K, Kindergarten, grade 1-12
Anything we should know about this child? Allergies/accommodations needed
Has he/she been baptized?
No
Yes, at St. Alphonsus
Yes, at another Catholic Church
Yes, in another christian denomination
If baptized other than St. Alphonsus, please name the CHURCH and LOCATION (city, state, country).
Has he/she received the Sacrament of First Communion?
Yes
No
Has he/she been received the Sacrament of Confirmation?
Yes
No
Child #3
First Name
Last Name
Birthdate
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Please select a year
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Where was the child born (city, state, country)?
What grade in 2024-25? Infant/Toddler, Pre-K, Kindergarten, grade 1-12
Anything we should know about this child? Allergies/accommodations needed
Has he/she been baptized?
No
Yes, at St. Alphonsus
Yes, at another Catholic Church
Yes, in another christian denomination
If baptized other than St. Alphonsus, please name the CHURCH and LOCATION (city, state, country).
Has he/she received the Sacrament of First Communion?
Yes
No
Has he/she been received the Sacrament of Confirmation?
Yes
No
Child #4
First Name
Last Name
Birthdate
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Please select a year
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Where was the child born (city, state, country)?
What grade in 2024-25? Infant/Toddler, Pre-K, Kindergarten, grade 1-12
Anything we should know about this child? Allergies/accommodations needed
Has he/she been baptized?
No
Yes, at St. Alphonsus
Yes, at another Catholic Church
Yes, in another christian denomination
If baptized other than St. Alphonsus, please name the CHURCH and LOCATION (city, state, country).
Has he/she received the Sacrament of First Communion?
Yes
No
Has he/she been received the Sacrament of Confirmation?
Yes
No
Child #5
First Name
Last Name
Birthdate
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Please select a year
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Where was the child born (city, state, country)?
What grade in 2024-25? Infant/Toddler, Pre-K, Kindergarten, grade 1-12
Anything we should know about this child? Allergies/accommodations needed
Has he/she been baptized?
No
Yes, at St. Alphonsus
Yes, at another Catholic Church
Yes, in another christian denomination
If baptized other than St. Alphonsus, please name the CHURCH and LOCATION (city, state, country).
Has he/she received the Sacrament of First Communion?
Yes
No
Has he/she been received the Sacrament of Confirmation?
Yes
No
Child #6
First Name
Last Name
Birthdate
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Please select a year
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Where was the child born (city, state, country)?
What grade in 2024-25? Infant/Toddler, Pre-K, Kindergarten, grade 1-12
Anything we should know about this child? Allergies/accommodations needed
Has he/she been baptized?
No
Yes, at St. Alphonsus
Yes, at another Catholic Church
Yes, in another christian denomination
If baptized other than St. Alphonsus, please name the CHURCH and LOCATION (city, state, country).
Has he/she received the Sacrament of First Communion?
Yes
No
Other
Has he/she been received the Sacrament of Confirmation?
Yes
No
Back
Next
Medical Authorization I understand that the parish of St. Alphonsus assumes no responsibility for accidents which may occur in association with parish events and activities. I agree to use my/our personal insurance to cover any such incidents. I understand that, in the event medical intervention is needed, every attempt will be made to contact the persons listed above. In the event those individuals cannot be reached, I/We hereby give permission to the physician or any other qualified medical staff selected by the event leader to hospitalize, secure medical treatment, and/or order injection, anesthesia, or surgery for Participant as deemed necessary.
*
YES I agree
NO I do not agree
Permission for Other Medical Matters: YES, in the event it comes to the attention of the parish staff or volunteers that my child complains of illness, I grant permission for non-prescription medication (such as Tylenol, lozenges, etc.) to be given to Participant.
*
YES I agree
NO I do not agree
Release of Liability for Youth and Adults:I understand all reasonable safety precautions will be taken at all times by the parish of St. Alphonsus, its employees and agents during the events and activities. I understand the possibility of unforeseen hazards and know the inherent possibility of risk. I agree to indemnify and hold harmless the parish of St. Alphonsus, its leaders, employees and volunteer staff from any and all claims arising from or in connection with attending this program.
*
YES I agree
NO I do not agree
Code of Behavior for Youth and Adults: I agree to abide by and/or instruct my child to abide by all rules and regulations as outlined by the aforementioned chaperones/ representatives. I agree that if I/Participant fail(s) to abide in any way by the rules, that I/Participant can be dismissed from the event and sent home immediately at my/Participant’s expense with no right of reimbursement or refund for any amount in connection therewith from the parish of St. Alphonsus or its volunteers.
*
YES I agree
NO I do not agree
Photo Release: YES, I hereby authorize St. Alphonsus, the Diocese of Davenport and its agents to utilize photographic and/or video images of me or my child by St. Alphonsus parish and the Diocese of Davenport. In giving my consent, I hereby indemnify and hold harmless St. Alphonsus parish, the Diocese of Davenport and its agents from any and all responsibility of liability. I understand that I will receive no compensation should any photograph and/or video of me or my child be used.
*
YES I agree
NO I do not agree
BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
*
Back
Next
Faith Formation Programs
SELECT ALL THAT APPLY. For more details about each of these programs, visit our parish faith formation website here: stalphonsusfaithformation.weebly.com or call the office at (319)385-8410.
I am interested in the following programs for my family - check all that apply.
*
The success of these programs is largely dependent on the volunteers who come forward to share their gifts with the parish. Please write below how you would like to share your gifts with the parish.
If you are feeling called to help in one of the above programs, please list them here and someone will be in contact with you about the details.
Submit
Should be Empty: