Faith Formation Program Registration Form
Family Last Name
Site
Year
Father's Full Name
First Name
Last Name
Religion (Father)
Mother's Full Name
First Name
Last Name
Religion (Mother)
Mother's Maiden Name
Address (of custodial parent/s)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
E-mail
example@example.com
Home Phone
Format: (000) 000-0000.
Mother Cell Ph#
Format: (000) 000-0000.
Father Cell Ph#
Format: (000) 000-0000.
Non-custodial Parent (if applicable)
First Name
Last Name
Religion (Non-custodial Parent)
Address (Non-custodial Parent)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
E-mail (Non-custodial Parent)
example@example.com
Home Phone (Non-custodial Parent)
Format: (000) 000-0000.
Other Phone (Non-custodial Parent)
Format: (000) 000-0000.
Emergency Contact Name
First Name
Last Name
Relationship
Home Phone (Emergency Contact)
Format: (000) 000-0000.
Cell Phone (Emergency Contact)
Format: (000) 000-0000.
Children/Youth to Register
Rows
Name (First/Middle/Last)
Birth Date
Gender (M/F)
Age
Grade
Baptism (Y/N)
Reconciliation (Y/N)
Communion (Y/N)
Confirmation (Y/N)
Child 1
Child 2
Child 3
Child 4
Child 5
Please list all persons living in your home:
Do any of the children enrolled have chronic illnesses or physical limitations?
Yes
No
Do any of the children have any type of learning difficulty?
Yes
No
Do any of the children attend special education classes or utilize a 504 or IEP Plan in the public school?
Yes
No
If yes to any of these questions, please give the name of the child, any information we made need, and how we can help:
If you are new to our program, please indicate level of prior Faith Formation training and any other information you feel would help us in working with your child/children:
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