Faith Formation Registration Form – St. John the Evangelist

ADULT CONTACT INFORMATION

Primary Contact

First Name *

Last Name *

Relationship to Child(ren) *

Email *

Phone *

Secondary Contact

First Name

Last Name

Relationship to Child(ren)

Phone

Emergency Contact

First Name *

Last Name *

Relationship to Child(ren) *

Email *

Phone *

Adress

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Zip / Postal Code

Country

Other

YOUTH INFORMATION

Number of Children Registering

Child #1

First Name *

Last Name *

Gender *

Date of Birth *

Age as of Sept. 1, 2019 *

Grade 19/20 School Year *

School Attending *

Allergies, medications, or other specific relevant needs: *

Child #2

First Name *

Last Name *

Gender *

Date of Birth *

Age as of Sept. 1, 2019 *

Grade 19/20 School Year *

School Attending *

Allergies, medications, or other specific relevant needs: *

Child #3

First Name *

Last Name *

Gender *

Date of Birth *

Age as of Sept. 1, 2019 *

Grade 19/20 School Year *

School Attending *

Allergies, medications, or other specific relevant needs: *

Child #4

First Name *

Last Name *

Gender *

Date of Birth *

Age as of Sept. 1, 2019 *

Grade 19/20 School Year *

School Attending *

Allergies, medications, or other specific relevant needs: *

Child #5

First Name *

Last Name *

Gender *

Date of Birth *

Age as of Sept. 1, 2019 *

Grade 19/20 School Year *

School Attending *

Allergies, medications, or other specific relevant needs: *

Child #6

First Name *

Last Name *

Gender *

Date of Birth *

Age as of Sept. 1, 2019 *

Grade 19/20 School Year *

School Attending *

Allergies, medications, or other specific relevant needs: *

If you or any of your children haven’t received one of the Sacraments of Initiation (Baptism, Eucharist or Confirmation), do you seek to receive any of them? *

(In the Diocese of Winona-Rochester 1st Eucharist is celebrated in 2nd grade and Confirmation in 10th grade).

Activities, sports, and extracurricular activities your child is involved in:

For 6th-9th graders

If you have a friend or two whose Confirmation small group you hope to be in, please indicate here:

Fees: *

K-8th Grade Faith Formation 1 Child - $ 50.00
K-8th Grade Faith Formation 2 Children - $ 80.00
K-8th Grade Faith Formation 3+ Children - $ 110.00
9th Grade Confirmation - $ 50.00
10th Grade Confirmation (includes overnight retreat) - $ 60.00
1st Communion & 1st Reconciliation Prep (In Addition to Faith Formation Cost) - $ 50.00

Total

360.00

***tuition assistance and payment schedules available upon request – credit is given to teachers with children in the program

PHOTO DISCLAIMER

I hereby authorize and give full consent, without limitation or reservation, to the Co-Cathedral of St. John the Evangelist, to publish any photograph or video in which my child(ren), named above, appear(s) while participating in any program associated with St. John's. There will be no compensation for use of any photograph or video at the time of publication or in the future.

Date

Parent Signature

Kindergarten-10thGrade Registration Form 2019/2020

ADULT CONTACT INFORMATION

Primary Contact

Secondary Contact

Emergency Contact

Adress

YOUTH INFORMATION

Child #1

Child #2

Child #3

Child #4

Child #5

Child #6

PHOTO DISCLAIMER

Kindergarten-10^thGrade Registration Form 2019/2020