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Mass Times, Confession, Adoration, Rosary
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Bulletins
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Announcements
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Home
About
About Our Parish
Staff and Parish Boards
Register/Directions/Contact us
Potential New Church Plans
Liturgy/Sacraments
Mass Times, Confession, Adoration, Rosary
Stations/Estaciones
Sacraments
Faith Formation
Faith Formation For Children
Faith Formation Registration
Youth Ministries
For Adults
Ministries
Liturgical Ministries
Parish Groups
Social Justice
Parish Life
Calendar
Bulletins
Announcements
Give
Photo Albums
Catholic Links
Faith Formation Family Registration
Faith Formation
Faith Formation For Children
Faith Formation Registration
Youth Ministries
For Adults
Faith Formation Family Registration 2023 - 2024
The maximum number of form submissions has been reached. This form is currently not available.
Family/Guardian Last Name
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Mailing Address
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Primary Phone Number
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Parent #1 contact information
First Name
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Last Name
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Email
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Do you check this email at least once a week?
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Cellular Number
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Work Number
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Religious Affiliation (if any)
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Parent #2 contact information
First Name
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Last Name
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Address (if different than above)
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City
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State
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AK
AL
AR
AS
AZ
CA
CO
CT
DC
DE
FL
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MH
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
PW
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Zip
Please enter a zip code.
Email
Please enter an email address.
Do you check this email at least once a week?
Yes
No
Primary Phone Number
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Work Number
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Religious Affiliation (if any)
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Number of students registering
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Student 1
First Name
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Last Name
REQUIRED
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Please enter valid data.
Birthdate
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Gender
Please enter valid data.
Grade
Please enter valid data.
Does your child need to prepare to receive Sacraments
REQUIRED
Yes.
No.
Please fill out this field.
Sacraments Needed:
Baptism
First Reconciliation
Confirmation
First Communion
Please list any pertinent information, special needs or considerations (allergies, learning disabilities, etc.):
Please enter valid data.
Current Tetanus Shot
Yes
No
List any medications taken:
Please enter valid data.
Family physician:
REQUIRED
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Family physician phone number:
REQUIRED
Maximum 20 characters
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Please enter a phone number.
Medical Insurance Company Name and Policy Number:
Please enter valid data.
Emergency contact (other than parent):
REQUIRED
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Please enter valid data.
Emergency Contact phone number:
REQUIRED
Maximum 20 characters
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Please enter a phone number.
Medical Release:
I have fully read the following medical release and sign voluntarily with knowledge of its terms and conditions:
Medical Release
Yes/ I Agree (Medical release)
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Publicity Release:
I have fully read the following publicity release and sign voluntarily with knowledge of its terms and conditions:
Publicity Release
Publicity Release: Please Mark One
REQUIRED
No/I Don't Agree
Yes/I Agree
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Student 2
First Name
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Please enter valid data.
Last Name
REQUIRED
Please fill out this field.
Please enter valid data.
Birthdate
Please enter valid data.
Gender
Please enter valid data.
Grade
Please enter valid data.
Does your child need to prepare to receive Sacraments
REQUIRED
Yes.
No.
Please fill out this field.
Sacraments Needed:
Baptism
First Reconciliation
Confirmation
First Communion
Please list any pertinent information, special needs or considerations (allergies, learning disabilities, etc.):
Please enter valid data.
Current Tetanus Shot
Yes
No
List any medications taken:
Please enter valid data.
Family physician:
REQUIRED
Please fill out this field.
Please enter valid data.
Family physician phone number:
REQUIRED
Maximum 20 characters
Please fill out this field.
Please enter a phone number.
Medical Insurance Company Name and Policy Number:
Please enter valid data.
Emergency contact (other than parent):
REQUIRED
Please fill out this field.
Please enter valid data.
Emergency Contact phone number:
REQUIRED
Maximum 20 characters
Please fill out this field.
Please enter a phone number.
Medical Release:
I have fully read the following medical release and sign voluntarily with knowledge of its terms and conditions:
Medical Release
Yes/ I Agree (Medical release)
Please select this field.
Publicity Release:
I have fully read the following publicity release and sign voluntarily with knowledge of its terms and conditions:
Publicity Release
Publicity Release: Please Mark One
REQUIRED
No/I Don't Agree
Yes/I Agree
Please fill out this field.
Student 3
First Name
REQUIRED
Please fill out this field.
Please enter valid data.
Last Name
REQUIRED
Please fill out this field.
Please enter valid data.
Birthdate
Please enter valid data.
Gender
Please enter valid data.
Grade
Please enter valid data.
Does your child need to prepare to receive Sacraments
REQUIRED
Yes.
No.
Please fill out this field.
Sacraments Needed:
Baptism
First Reconciliation
Confirmation
First Communion
Please list any pertinent information, special needs or considerations (allergies, learning disabilities, etc.):
Please enter valid data.
Current Tetanus Shot
Yes
No
List any medications taken:
Please enter valid data.
Family physician:
REQUIRED
Please fill out this field.
Please enter valid data.
Family physician phone number:
REQUIRED
Maximum 20 characters
Please fill out this field.
Please enter a phone number.
Medical Insurance Company Name and Policy Number:
Please enter valid data.
Emergency contact (other than parent):
REQUIRED
Please fill out this field.
Please enter valid data.
Emergency Contact phone number:
REQUIRED
Maximum 20 characters
Please fill out this field.
Please enter a phone number.
Medical Release:
I have fully read the following medical release and sign voluntarily with knowledge of its terms and conditions:
Medical Release
Yes/ I Agree (Medical release)
Please select this field.
Publicity Release:
I have fully read the following publicity release and sign voluntarily with knowledge of its terms and conditions:
Publicity Release
Publicity Release: Please Mark One
REQUIRED
No/I Don't Agree
Yes/I Agree
Please fill out this field.
Student 4
First Name
REQUIRED
Please fill out this field.
Please enter valid data.
Last Name
REQUIRED
Please fill out this field.
Please enter valid data.
Birthdate
Please enter valid data.
Gender
Please enter valid data.
Grade
Please enter valid data.
Does your child need to prepare to receive Sacraments
REQUIRED
Yes.
No.
Please fill out this field.
Sacraments Needed:
Baptism
First Reconciliation
Confirmation
First Communion
Please list any pertinent information, special needs or considerations (allergies, learning disabilities, etc.):
Please enter valid data.
Current Tetanus Shot
Yes
No
List any medications taken:
Please enter valid data.
Family physician:
REQUIRED
Please fill out this field.
Please enter valid data.
Family physician phone number:
REQUIRED
Maximum 20 characters
Please fill out this field.
Please enter a phone number.
Medical Insurance Company Name and Policy Number:
Please enter valid data.
Emergency contact (other than parent):
REQUIRED
Please fill out this field.
Please enter valid data.
Emergency Contact phone number:
REQUIRED
Maximum 20 characters
Please fill out this field.
Please enter a phone number.
Medical Release:
I have fully read the following medical release and sign voluntarily with knowledge of its terms and conditions:
Medical Release
Yes/ I Agree (Medical release)
Please select this field.
Publicity Release:
I have fully read the following publicity release and sign voluntarily with knowledge of its terms and conditions:
Publicity Release
Publicity Release: Please Mark One
REQUIRED
No/I Don't Agree
Yes/I Agree
Please fill out this field.
We encourage all children to particpate regardless of a family's ability to pay. If you need financial assistance, please email
Cory Dixon
.
Registration Fee Student #1
45.0
– (PreK thru 6th grade)
75.0
– (7th thru 12th grade)
Registration Fee Student #2
45.0
– (Pre-K thru 6th grade)
75.0
– (7th thru 12th grade)
Registration Fee Student #3
22.5
– (Pre-K thru 6th grade)
37.5
– (7th thru 12th grade)
Registration Fee Student #4
11.25
– (Pre-K thru 6th grade)
18.75
– (7th thru 12th grade)
Total:
Submit
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