Altar Server Registration Form

Altar Server Regstration Form Immaculate Conception Monastery Church

86-45 Edgerton Blvd. Jamaica, NY 11432
Name

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
My child attends school.
Current grade:
Parent phone Number
Format: (000) 000-0000.
Parent/Guardian email
example@example.com
Serving Mass: What mass would your child like to be schduled for:
How often does your child want to serve?
What size robe will your child need?
New Servers must complete three (3) All sessions are from 3:00 PM to 4:15 PM in the upper church. Please choose three dates
Comments or quesitons
Fr. Jim/Fr. Anibal, I give permisison for my son/daughter to be an Altar Server at Immaculate Conception
Parent name
Any questions please email Fr. Jim Price, C.P. @ immaculateserversja@gmail.com
Should be Empty:

Altar Server Regstration Form Immaculate Conception Monastery Church