Fields marked with an * are required Family Faith Formation Registration Form Family Contact Information Parent/Guardian (primary contact): First Name * Last Name * Maiden name (if applicable) Relationship to Child * Phone Number * Parent/Guardian: First Name * Last Name * Maiden name (if applicable) Relationship to Child * Phone Number * Email * Family Mailing Address: Address * City * US States * - Select State - Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Washington DC ARMED FORCES AFRICA \ CANADA \ EUROPE \ MIDDLE EAST ARMED FORCES AMERICA (EXCEPT CANADA) ARMED FORCES PACIFIC Zip * At which parish is your family currently registered? * Saint Leonard Saint Frances of Rome Neither, but we want to join! Neither, but there are special circumstances (please explain and include the name of the parish where you are currently registered) If special circumstance: Divider Student Information Child 1 First Name * Last Name * Date Of Birth * Grade Of Current/Upcoming School Year * Check all sacraments received: * Baptism First Communion Confirmation Date Of Baptism * Church of Baptism * City and state of church of Baptism * * Please reach out to the Director of Formation if your child is older than the traditional age for First Communion (2nd grade) or Confirmation (8thgrade) but has not yet received this sacrament so we can include them in the program. Divider Copy Health And Safety Information Please describe any allergies or medical conditions that we should be aware of for your child: * Photo Release: May we have permission to photograph your child for parish news and promotions? * Yes No Custodial Authorization: Is there anyone else you want to designate to be able to take your child home? * Yes No If yes with custodial authorization, then who? During the 2022 – 2023 school year, some faith formation activities may take place via video chat platforms such as Zoom; all session facilitators will be trained in compliance with Archdiocesan Safe Environment policies. During these sessions, a parent or guardian must be present in the room with their child and visible on the screen throughout the session. Sign and date below to indicate that you understand and will comply with this requirement. If you do not wish your child(ren) to participate in sessions digitally, please contact the Director of Faith Formation to arrange alternative opportunities for formation. E-Signature * Date * Divider Program and Retreat Fees The faith formation program fee is $25 per family; if this poses a hardship for your family, please contact the Pastoral Associate at your parish office. Please pay by cash or check made out to either “Saint Leonard Parish” or “Saint Frances of Rome Church,” and return this form and attached payment to your parish office. Thanks! If you are a human seeing this field, please leave it empty.
