St. Columba Faith Formation Registration Form

Family Name/Parent/Guardian(s):

Name

First NameLast Name

Address

Street Address Line 2

CityState

Zip Code

Email Please Print

example@example.com

Cell Phone: (Primary)

Cell Phone: (Secondary)

Emergency Contact (Not Parents): Name

Name

Phone

FIRST RECONCILIATION/COMMUNION: For children beginning 2nd Grade and have ALREADY completed at least one academic year in a faith formation program or Catholic school. *Children in 3rd grade or above are also eligible for this two (2) year formation. Please contact the Elementary Minister (k-5th) 334-944-6522

CONFIRMATION: This is a two-year process and begins either in 9th/10th grade and is completed in 11th/12th grade. The next class begins in the Fall of 2025. 11th/12th graders who are NOT Confirmed or NOT enrolled in the current Confirmation program, please contact the Youth Minister (6th-12th) to make special arrangements. 334-944-6523

Student 1 Name

DOB

School

Grade

Allergies

Previous Faith Formation Year

Parish

Enroll student in the 2nd Year of 1st Reconciliation/1 Communion Class:

YesNo

Sacraments Received in the Catholic Church

BaptismReconciliationCommunionConfirmation

Date of Baptism

Date

Parish Church

Address of Church

Copy of Certificate included?

YesNo

Student #2 Name

Date of Birth

Date

School

Grade

Allergies

Previous Faith Formation Year

Parish

Enroll student in the 2nd Year of 1st Reconciliation/1s Communion Class:

YesNo

Sacraments Received in the Catholic Church:

BaptismReconciliationCommunionConfirmation

Date of Baptism

Date

Parish/Church

Address of Church

Copy of certificate included?

YesNo

Student #3 Name

Date of Birth

Date

School

Grade

Allergies

Previous Faith Formation Year Parish

Enroll student in the 2nd Year of 1st Reconciliation/1st Communion Class?

YesNo

Sacraments Received in the Catholic Church:

BaptismReconciliationCommunionConfirmation

Date of Baptism

Date

Parish Church

Address of Church

Copy of certificate included?

YesNo

St. Columba Faith Formation Parental Consent/Medical Release Form

Children are not allowed to be admitted to classes/events unless this completed Parental Consent Form and a Medical Release form is on file. I understand that I am required to read the policies and rules listed in the Handbook on the parish website. By enrolling the children of my family/guardianship in the St. Columba Catholic Church Faith Formation for the 2024-2025 year, which is from August 25, 2024 - September 1, 2025, I consent to abide by the policies stated in the handbook. I understand that failure to comply with this policy could bring about disciplinary actions including, in extreme cases, dismissal of my child from the Faith Formation program. I understand that I am responsible for sharing the rules, regulations, and other valuable information in this handbook with my child. I permit my child to participate in all activities offered on St. Columba grounds during normal Faith Formation times throughout August 25, 2024- September 1, 2025. As a parent and/or guardian, I do herewith authorize the treatment, by a qualified and licensed medical doctor, of the following minor(s) in the event of a medical emergency which, in the opinion of the attending physicians, may endanger his or her life, cause disfigurement, physical impairment or undue discomfort if delayed. This authority is granted only after a reasonable effort has been made to reach me. This release will be in effect from August 25, 2024- September 1, 2025. This release form is completed and signed of my own free will with the sole purpose of authorizing medical treatment under emergency circumstances in my absence.

Parent or legal guardian signature

Date

*Occasionally photographs, articles, social media posts, etc. of your student may be used for ministry outreach, bulletins, reminders and informative parish marketing. You may choose to limit or forgo the use of photography, names or other information used by official parish communications. Please complete the Faith Formation Communication Exception Form if you wish to limit or forgo your child's image, name, etc. from official parish media communication. This form can be found online.

List of medications that would affect medical treatment for each child: (List may be provided)

NAME

List of food, medicine, and/or environmental allergies for each child: (List may be provided)

NAME

Registration Fees Please make checks payable to St. Columba Church $25 per Student/Adult - Grades K5-12 An Additional $25 per Student registered for First Communion (Total of $50 per student in First Communion) *Payment due at the beginning of 2024 -2025 Academic Year

Venmo- @stcolumbadothan

Registration Fee Date Paid

Date

Payment Method

CashCheckVenmoOSV