2024-2025 OCIA Registration Form
St. Thomas the Apostle & Ss. Peter and Paul
Registrant Information
Registrant's Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parish
Please Select
St. Thomas
Ss. Peter and Paul
Other
If other, name parish
Name of Parish
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Sacrament Information
Religion of Origin
Sacraments Received
Baptism
Confession
First Communion
Confirmation
Have you ever been married?
Please Select
Yes
No
If yes, were you married in the Catholic Church?
Have you ever been divorced or received an annulment?
Please Select
Yes
No
If yes, please explain
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Medical Information
Please indicate if the registrant has i.e. allergies, ADHD, required medication(s), etc. Section must be completed.
Registrant name and medical information
Health Plan Name
Carrier Number
Doctor
Phone Number
Please enter a valid phone number.
Parent/Guardian fill out if registrant is under 18 years old.
Parent/Guardian(s) Full Name(s), Phone, Email, and Religion
Emergency Medical Information
In the event of an emergency, I give permission to transport my child to a hospital for emergency medical treatment. I wish to be advised before further treatment by a doctor or hospital. In the event of an emergency, if you are unable to reach me at the above numbers, contact:
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
I,________________________________, grant permission for my child who is named above to participate in the Religious Education Program at St. Thomas the Apostle and Ss. Peter and Paul. In consideration of my child's participation, I agree to idemnify the Parish and the Archdiocese of St. Paul & Minneapolis, from any claims or law suits brought against the Parish and Archdiocese of St. Paul & Minneapolis by myself, my child, or others that arise out of any behavior by my child in the classes and activities included in this program. I also agree to pay reasonable attorney's fees or expenses incurred by the Parish and the Archdiocese in defense of such a claim/law suit. *Should photos or video be taken, I give my permission for the use of the image and/or likeness of my child in any promotional or other marketing activities relating to the event/activity or our Parish Youth Ministry without compensaiton to me or my child.
Type Name
Date
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Month
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Day
Year
Date
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