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FAMILY INFORMATION

PARENTS: Do you need to celebrate any of the Sacraments?
Sacraments Needed:
Sacraments Needed:
Marriage Status:

STUDENT #1 INFORMATION

Languages spoken:

If you answer NO to any of the following questions, meaning your child has already celebrated the listed Sacrament, let us know where and what year.

**Please provide copies of the certificates of the Sacraments that have been celebrated. **

Does your child need to celebrate Baptism?
Does your child need to celebrate Reconciliation?
Does your child need to celebrate First Eucharist?
Does your child need to celebrate Confirmation?

STUDENT #2 INFORMATION

Languages spoken:

If you answer NO to any of the following questions, meaning your child has already celebrated the listed Sacrament, let us know where and what year.

**Please provide copies of the certificates of the Sacraments that have been celebrated. **

Does your child need to celebrate Baptism?
Does your child need to celebrate Reconciliation?
Does your child need to celebrate First Eucharist?
Does your child need to celebrate Confirmation?

STUDENT #3 INFORMATION

Languages spoken:

If you answer NO to any of the following questions, meaning your child has already celebrated the listed Sacrament, let us know where and what year.

**Please provide copies of the certificates of the Sacraments that have been celebrated. **

Does your child need to celebrate Baptism?
Does your child need to celebrate Reconciliation?
Does your child need to celebrate First Eucharist?
Does your child need to celebrate Confirmation?

STUDENT #4 INFORMATION

Languages spoken:

If you answer NO to any of the following questions, meaning your child has already celebrated the listed Sacrament, let us know where and what year.

**Please provide copies of the certificates of the Sacraments that have been celebrated. **

Does your child need to celebrate Baptism?
Does your child need to celebrate Reconciliation?
Does your child need to celebrate First Eucharist?
Does your child need to celebrate Confirmation?

MEDICAL INFORMATION AND RELEASE FORM

Name of child registered:

Age:

Insurance Carrier:

Policy number:

Physician's name  and  telephone: 

Please list any special medical information for your children. (for example: special medications or any educational accommodations needed). Also include the name of the child and allergies if any.

In the event of illness or injury, I do hereby consent to whatever x-ray examination, anesthetic, medical, surgical, dental diagnosis, or treatment and hospital care are considered necessary in the best judgment of the attending physician, surgeon, or dentist and performed by or under the supervision of a member of the medical staff of the hospital or facility furnishing medical or dental services.


I fully understand that students are to abide by all rules and regulations governing conduct and safety while attending religious education classes and related activities. Any violation of these rules and regulations may result in that individual being sent home.

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This form will be effective starting the date of submission until 2022.

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