FIRE REGISTRATION – CHILDREN’S FAITH FORMATION

Family Last Name*

Home Address*

Parent/Guardian #1 – Full Name*

Parent/Guardian #1 cell number and email address

Relationship to Child/Children*

Mother
Father
Guardian
Other

Parent/Guardian #2 – Full Name

Paren/Guardian # 2 cell number and email address

Relationship to Child/Children

Mother
Father
Guardian
Other

NAME OF EMERGENCY CONTACT IN CASE PARENT/GUARDIAN CANNOT BE REACHED

EMERGENCY CONTACT PHONE NUMBER

EMERGENCY CONTACT EMAIL ADDRESS

Parish where family is registered

Name of Child #1*

First Middle Last

Date of Birth*

Gender*

Male
Female

Any allergies, medical issues, special learning needs, etc, we should know about?*

Has the child been Baptized?*

Yes
No
Not Sure

Parish, city and state of baptism*

Date of Baptism

Has this child had First Reconciliation and Communion?*

Yes
No
Unsure

Parish, city and state where child receive First Reconciliation and Communion*

Previous Religious Education. Where and When*

What school does this child attend?*

Current grade in school*

Choose One:*

I authorize and give full consent to photograph my child during parish activities and events. This may be used in the parish bulletin or website.
I Do Not authorize the above photography consent

Are you registering a 2nd child?*

Yes
No

Name of Child #2*

First Middle Last

Date of Birth of Child #2*

Gender*

Male
Female

Any allergies, medical issues, special learning needs, etc, we should know about?*

Has child #2 been Baptized?*

Yes
No
Not Sure

Parish, city and state of baptism*

Date of Baptism

Has child #2 had First Reconciliation and Communion?*

Yes
No
Unsure

Parish, city and state where child receive First Reconciliation and Communion*

What school does this child attend?*

Current grade in school*

Choose One:*

I authorize and give full consent to photograph my child during parish activities and events. This may be used in the parish bulletin or website.
I Do Not authorize the above photography consent

Are you registering a 3rd Child?

Yes
No

Name of Child #3*

First Middle Last

Date of Birth of Child #3*

Gender*

Male
Female

Any allergies, medical issues, special learning needs, etc, we should know about?

Has child #3 been Baptized?*

Yes
No
Not Sure

Parish, city and state of baptism*

Date of Baptism*

Has child #3 had First Reconciliation and Communion?*

Yes
No
Unsure

Parish, city and state where child receive First Reconciliation and Communion*

What school does this child attend?*

Current grade in school*

Choose One:*

I authorize and give full consent to photograph my child during parish activities and events. This may be used in the parish bulletin or website.
I Do Not authorize the above photography consent

FIRE REGISTRATION – CHILDREN’S FAITH FORMATION

Registration for FIRE and First Reconciliation & Communion