St. Elizabeth Ann Seton Catholic CommunityCATECHETICAL MINISTRY REGISTRATION FORM 2026-2027
2713 S. Grove Avenue, Ontario, CA 91761 Phone: 909-947-2956
CHILD (CHILDREN) LIVES WITH
MOTHER
FATHER
BOTH
Other
FAMILY PRIMARY LANGUAGE
TODAY'S DATE
-
Month
-
Day
Year
Date
Family Last Name:
Family Envelope #
Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Father's Name
First Name
Last Name
Cell Phone Number
Format: (000) 000-0000.
Mother's Name
First Name
Last Name
Cell Phone Number
Format: (000) 000-0000.
Father's Email:
example@example.com
Mother's Email:
example@example.com
EMERGENCY CONTACT - Name
Phone #
Format: (000) 000-0000.
Medical Insurance
Policy #
INFORMATION ON CHILDREN ATTENDING SEAS CATECHETICAL MINISTRY
INFORMATION ON CHILDREN ATTENDING SEAS CATECHETICAL MINISTRY
Rows
Child's BAPTISMAL First Name (and Last name if different from Family Name)
Date of Birth
Grade (as of Sept 2026)
Gender M/F
Sacraments Received
CM Level FHC 1 or 2, C1 or C2
SESSION (Office Use Only)
1
2
3
4
SEAS CM/PFF Sessions: Monday:
4:30-6:00PM
Grades 2-11 (FHC Year 1)
Tuesday:
4:30-6:00PM
First Reconciliation & First Communion (FHC Year 2)
Wednesday:
4:30-6:00PM
Grades 2-11 (FHC Year 1)
Monday:
6:30-8:00PM
High School Confirmation (Year C2)
Tuesday:
6:30-8:00PM
High School Confirmation (Year C1)
Parent/Family Gathering:
Once a Month
(See Calendar for Details)
Please answer the following questions in order to insure a safe and productive learning environment:
1. Do any of your children have a medical condition and/or severe allergy that we should know about? YES/NO
YES
NO
If "yes" list condition/allergy here:
Name of Child
Please let us know if you child has been diagnosed with any of the following
ADD
ADHD
ASD
Down Syndrome
Other
OTHER
If so, which Child? Name
Are there any special family situations of which we need to be aware?
YES/NO
If yes, please explain.
IF YOUR CHILD IS IN CONFIRMATION PROGRAM, FULL PAYMENT OF THE RETREAT FEE $85 for C1 AND
$200 for C2. NEED TO BE PAID IN FULL PRIOR TO RETREAT. RETREAT FEE IS NON-REFUNDABLE.
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Photo/Video Permission, Code of Conduct, and Medical Release Authorization
I agree
By checking this box, I Do note agree
I agree
I agree
I agree
I agree
(Initial)
example@example.com
Best Parent Email Address
example@example.com
I agree
I agree
By my signature below, I grant permission for my child(ren) to
participate
in St. Elizabeth Ann Catechetical Ministry under the guidance and direction of parish staff and/or volunteers. As parent/guardian, I remain legally responsible for any personal actions taken by the above-named minor(s).
Parent/Legal Guardian Signature
Name Printed
Date Signed
-
Month
-
Day
Year
Date
Encounter Christ. Grow in His Love. Live as His Disciple. Share the Good News.
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