Faith Formation and Youth Ministry Registration
St. John Vianney Catholic Church
Child's Information
*
Child's Information
*
Child's Grade Level
*
Please Select
Kindergarten
1st
2nd
3rd
4th
5th
Middle School
High School
Sex
*
Male
Female
Date of Birth
*
-
Month
-
Day
Year
Date
Name of Child's School
*
Previous Religious Education Completed
*
Sacraments Already Received By Child
*
Baptism
First Reconciliation
First Holy Communion
Confirmation
Child's t-shirt size
*
Please Select
Y XS
Y S
Y M
Y L
Y XL
A S
A M
A L
A XL
Any allergies, medications, medical problems, etc. that we should know about?
*
Add another child?
Child's Information
Child's Grade Level
Please Select
Kindergarten
1st
2nd
3rd
4th
5th
Middle School
High School
Sex
Male
Female
Date of Birth
-
Month
-
Day
Year
Date
Name of Child's School
Previous Religious Education Completed
Sacraments Already Received By Child
Baptism
First Reconciliation
First Holy Communion
Confirmation
Child's t-shirt size
Please Select
Y XS
Y S
Y M
Y L
Y XL
A S
A M
A L
A XL
Any allergies, medications, medical problems, etc. that we should know about?
Add another child?
Child's Information
Child's Grade Level
Please Select
Kindergarten
1st
2nd
3rd
4th
5th
Middle School
High School
Sex
Male
Female
Date of Birth
-
Month
-
Day
Year
Date
Name of Child's School
Previous Religious Education Completed
Sacraments Already Received By Child
Baptism
First Reconciliation
First Holy Communion
Confirmation
Child's t-shirt size
Please Select
Y XS
Y S
Y M
Y L
Y XL
A S
A M
A L
A XL
Any allergies, medications, medical problems, etc. that we should know about?
Child(ren) live with
*
Please Select
Both parents
Mother
Father
For families who have custody agreements outlined by the court:
*
I acknowledge that by submitting this form, I am certifying that I have provided all necessary contact information for all parties who have custodial rights of this child and all parties have given consent for this child to receive Faith Formation instruction.
Family Information
Family Address
*
Name
Were parents married in the Catholic Church by a Catholic priest or deacon?
*
Yes
No
Parent Information
Mother's Name
*
Is Mother Catholic?
*
Yes
No
Mother's Email
*
Mother's Phone Number
*
Please enter a valid phone number.
Father's Name
*
Is Father Catholic?
*
Yes
No
Father's Email
*
Father's Phone Number
*
Please enter a valid phone number.
If either parent has a different address, please include it here:
Emergency Contact (if parents can't be reached)
Name
*
Phone Number
*
Please enter a valid phone number.
Relationship to Child(ren):
*
Permitted to Release Child(ren)
*
Please Select
Yes
No
Relationship to Child(ren)
*
Acknowledgments
I understand a copy of my child(ren)'s Baptismal Certificate (and all other Sacramental Certificates they have already received) must be on file.
*
Yes
No
I understand two (2) years of consecutive Faith Formation are required by the Diocese of St. Petersburg before a child can receive First Communion or Confirmation.
*
Yes
No
I understand Faith Formation takes place on Wednesday evenings from 5:30-8:30pm, from September through April.
*
Yes
No
I hereby certify that the information contained on this form is true and accurate.
*
Yes
No
Additional Notes
Promotional Media Release
Promotional Media Release
During the Faith Formation program year, your child(ren) may participate in the recorded, edited, reproduced, and distributed audio, video, or still imaging recordings that involve the use of students’ names, likenesses, or voices. Such productions may be used for educational or exhibition purposes by St. John Vianney Catholic Church in perpetuity and may be copied, copyrighted, edited and distributed by St. John Vianney Catholic Church in perpetuity unless said consent is revoked in writing. News media, including representatives of television, radio, newspapers and magazines, also sometimes are permitted on church property and may take notes, still photos, sound recordings and/or moving pictures that may include your child. These items may appear or be used in news or feature stories by any media format. You have the right to object to the use of your child’s name, picture or voice in these productions and may do so by completing the form below and returning it to the Faith Formation Coordinator for St. John Vianney Catholic Church. If you have any questions, please contact the parish office at (727) 360-1147 or via email faithformation@sjvcc.org
I/We, the undersigned
*
Please Select
DO
DO NOT
hereby consent that St. John Vianney Catholic Church may use the name, likeness, and/or voice of my child for the parish website, social media, and promotional activities. This consent is renewed at the beginning of each Faith Formation Program Year.
Parent's Signature
*
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