Faith Formation Registration

Father's Full Name

Father's Cell/Work Number

Father's E-mail

Mother's Full Name

Mother's Cell/Work Number

Mother's E-mail

Full Name

Cell/Work Number

E-mail

Picture Consent: Do we have your permission to take your child/children’s picture during the year for display in the hallway, bulletin, screen/website, etc. of different activities that they are involved in?YesNo

Protecting God’s Children Consent: The Diocese of Green Bay mandates that all parishes hold the equivalent of one class for each grade level, each year, regarding Safe Environment and Protecting God’s Children from harm. Do you give permission for your child to be a part of this class? YesNo

Child’s Name

Date of Birth

Grade Entering in Fall

School Attending

Faith Formation Class 4:40 (K-6)6:30 (1-10)

Baptism
YesNo

Parish of Baptism if not St. Bernard (include State)

First Reconcil-iation
YesNo

First Eucharist
YesNo

Special Needs – Including medical, learning & physical challenges

Child’s Name

Date of Birth

Grade Entering in Fall

School Attending

Faith Formation Class 4:40 (K-6)6:30 (1-10)

Baptism
YesNo

Parish of Baptism if not St. Bernard (include State)

First Reconcil-iation
YesNo

First Eucharist
YesNo

Special Needs – Including medical, learning & physical challenges

Child’s Name

Date of Birth

Grade Entering in Fall

School Attending

Faith Formation Class 4:40 (K-6)6:30 (1-10)

Baptism
YesNo

Parish of Baptism if not St. Bernard (include State)

First Reconcil-iation
YesNo

First Eucharist
YesNo

Special Needs – Including medical, learning & physical challenges

Child’s Name

Date of Birth

Grade Entering in Fall

School Attending

Faith Formation Class 4:40 (K-6)6:30 (1-10)

Baptism
YesNo

Parish of Baptism if not St. Bernard (include State)

First Reconcil-iation
YesNo

First Eucharist
YesNo

Special Needs – Including medical, learning & physical challenges