2026-2027 Youth Faith Formation Registration Form

2026-2027 Youth Faith Formation Registration Form
Last Name
Current Parish
Student Name #1
DOB

MonthDayYear
Date
Grade for 26-27
Is your child Baptized?
Student's School
Made First Communion?
Student Name #2
DOB

MonthDayYear
Date
Grade for 26-27
Is your child Baptized?
Student's School
Made First Communion?
Student Name #3
DOB

MonthDayYear
Date
Grade for 26-27
Is your child Baptized?
Student's School
Made First Communion?
Mother's Name (F. M, L & Maiden)(phone #)
Father's Name (F, M, L)(Phone#)
Mailing Address
Contact Number(s)
Email address:
example@example.com
EMERGENCY CONTACT INFORMATION: In the event the parent or guardian cannot be reached.
Name
Relationship
Phone #
Format: (000) 000-0000.
Medical Release: In the event the undersigned cannot be reached and in the judgement of the Director of Religious Education (DRE) or other person responsible for the program/group, or other appropriate staff member and there is a necessity for immediate examination and/or treatment of my child/children, I hereby authorize any of the aforesaid personnel to obtain such medical services as deemed necessary.
Parent Signature
Date

MonthDayYear
Date
CONFIDENTIAL Medical information and/or special needs (allergies, learning, etc.)
$70-1 Child, $110-2 Children, $150-3 Children or more
+$50-Out of Parish (not registered w/ St. Dominic, St. Anthony, or St. Augustine)
+$10-Sacramental fee for 1st Communion or Confirmation
Tuition Total:
Fee Total:
Total Amount:
**Make Checks Payable to Cluster School of Religion
For Office Use Only
Should be Empty:

2026-2027 Youth Faith Formation Registration Form

EMERGENCY CONTACT INFORMATION: In the event the parent or guardian cannot be reached.