Faith Formation Registration Form 2017-2018

St. Patrick's Parish Community

Welcome!  You may now fill out our Faith Formation Registration form for 2017-2018 on-line and all information will be CONFIDENTIAL!  Please stop in at our Parish office to remit payment. Thank you!

Father/Guardian
Name
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Address
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Phone --
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Phone --
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Phone -- ext
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E-mail
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Mother/Guardian
Name
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Address
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Phone --
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Phone --
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Phone -- ext
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E-mail
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Student Information
*If this is your child's first time registering please supply one copy of each child's baptismal certificate to Parish office. Thank you!
Name
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Birthdate //
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If your child is in Kindergarten, please indicate here.
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Grade
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Please indicate if your child/teen has received any of these Sacraments.
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Name
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Birthdate //
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If your child is in Kindergarten, please indicate here!
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Grade
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Please indicate if you child/teen has received any of these Sacraments.
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Name
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Birthdate //
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If your child is in Kindergarten, please indicate here.
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Grade
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Please indicate which Sacraments your child/teen has received.
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Name
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Birthdate //
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If your child is in Kindergarten, please indicate here!
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Grade
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Please indicate which Sacrament your child/teen has received.
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Name
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Birthdate //
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If your child is in Kindergarten, please indicate here!
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Grade
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Please indicate which Sacrament your child/teen has received.
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Contact in Case of Emergency
Name
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Phone --
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Phone --
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Phone -- ext
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Special Needs or Health Concerns
Additional information that we need to know about your child/ren to be of help to him/her for example, learning disabilities, allergies, physical disabilities, medical problems, etc.
Student Name
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Age
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Allergies
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*Important* In the event that the undersigned, or my (emergency contact), cannot be reached and in the judgement of the Director of Religious Education or other person responsible for program/group, or other appropriate staff member, there is a necessity for immediate examination and /or treatment of my child, I (we) hereby authorize any of the aforesaid personnel to obtain for my (our) child such medical services as are deemed necessary. I agree to assume the financial responsibility for any diagnosis/treatment and for medication deemed necessary. Dates for which release is intended: September 6, 2017 to April 18, 2018.
*Signature of Parent/Guardian
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By typing in your name you agree to the terms stated.
Date //
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Xtreme Faith Choir
Please indicate if interested in Xtreme Faith Choir! Open to all youth grades 7th - 12th!
List (Multiple Choice)
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Name
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Please indicate name of youth interested in joining Xtreme Faith and the best contact number to reach them.
Publication Release
Please Read Carefully The activities of the Faith Formation Program are published on the St. Patrick’s website and Facebook. Although much of the information will be in word form, photos and other graphics will be an important part of our electronic publication. So, we need your permission to include photos of your child/children on the site. Know that we will follow suggested safety and privacy guidelines, no names or personal information will ever be posted on the St. Patrick’s website. Unless other written instruction is submitted, I also consent to allowing my child/children's image to be used during or after Faith Formation for Diocesan publication use: parish bulletin, the West Nebraska Register, or future advertisement of parish programs and other social media. Effective September 6, 2017 to April 18, 2018.
Please select one:
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*Signature of Parent/Guardian
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By typing in your name you agree to the terms stated.
Date //
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Registration Fee
Please read carefully. There is a $20.00 registration fee per participant, $35.00 for two; $45.00 for three; $50.00 for four or more. In order to complete registration payment may be mailed to: St. Patrick's Catholic Church c/o Religious Education Program P. O. Box 99, Sidney, NE 69162. Make checks payable to: St. Patrick's Catholic Church. If payment is a hardship, please let us know, financial assistance is available upon request. Call Joan at (308) 254-2828 or e-mail: dirreled@sidneystpats.com. Thank you!
Payment Options
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Please make selection.
Volunteer Opportunities!
Please consider, we need awesome volunteers, like you!
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Catechist, Co-Catechist, Catechist Substitute, and Assistant
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If you are interested in helping with our FAITH FORMATION program, please indicate GRADE PREFERENCE. Thank you!
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