Faith Formation 2021 – 2022 Please complete and submit this form by July 15, 2021 and return your payment ($25/child, $75/family max) to the church office. We cannot guarantee that we can accommodate late registrations. If you have any questions about completing this form or payment, please contact Loretta Hudy at 607-785-4581 or at lorettahudy@gmail.com. Note: A Baptismal Certificate is required for First Reconciliation, First Eucharist, and Confirmation students if not baptized at Church Of The Holy Family or Christ The King. PARENT INFORMATION :Parent or Guardian Name* Parent or Guardian Mailing Address*(i.e., Street, City, State, Zip Code)Email* Home Phone Number*( i.e., ### - #### )Emergency Contact Name*Emergency Contact Phone Number*( i.e., ### - #### )What is your home parish?Church of the Holy FamilyMost Holy RosaryIf "Other", please enter home parish name.School District* Photographs and/or videos of minors are taken periodically for use in parish publications. In selecting "Yes" you are acknowledging this and granting permission to use photos and videos of your child(ren) and their names in publications and displays. Do you consent?*YesNoWhat type of students are you registering?*New student(s)Returning student(s)Both New and Returning Student(s)RETURNING STUDENT INFORMATION :Returning Student 1Returning Student 1 Name First Last Grade(Entering September 2021)AllergiesPlease note any food or medical allergies that we need to be aware of.Has this child been baptized?YesNoBaptism DateChurch (include city)Has this child received First Communion?YesNo1st Communion DateChurch (include city)Has this child received First Penance?YesNo1st Penance DateChurch (include city)Would you like to register another returning student?YesNoReturning Student 2Returning Student 2 Name First Last Grade(Entering September 2021)AllergiesPlease note any food or medical allergies that we need to be aware of.Has this child been baptized?YesNoBaptism DateChurch (include city)Has this child received First Communion?YesNo1st Communion DateChurch (include city)Has this child received First Penance?YesNo1st Penance DateChurch (include city)Would you like to register another returning student?YesNoReturning Student 3Returning Student 3 Name First Last Grade(Entering September 2021)AllergiesPlease note any food or medical allergies that we need to be aware of.Has this child been baptized?YesNoBaptism DateChurch (include city)Has this child received First Communion?YesNo1st Communion DateChurch (include city)Has this child received First Penance?YesNo1st Penance DateChurch (include city)Would you like to register another returning student?YesNoReturning Student 4Returning Student 4 Name First Last Grade(Entering September 2020)AllergiesPlease note any food or medical allergies that we need to be aware of.Has this child been baptized?YesNoBaptism DateChurch (include city)Has this child received First Communion?YesNo1st Communion DateChurch (include city)Has this child received First Penance?YesNo1st Penance DateChurch (include city)Would you like to register another returning student?YesNoReturning Student 5Returning Student 5 Name First Last Grade(Entering September 2020)AllergiesPlease note any food or medical allergies that we need to be aware of.Has this child been baptized?YesNoBaptism DateChurch (include city)Has this child received First Communion?YesNo1st Communion DateChurch (include city)Has this child received First Penance?YesNo1st Penance DateChurch (include city)_______________________________________________________________NEW STUDENT INFORMATION :New Student 1New Student 1 NameGrade(Entering September 2021)Date of Birth(MM/DD/YYYY)AllergiesPlease note any food or medical allergies that we need to be aware of.Has this child been baptized?YesNoBaptism DateChurch (include city)Has this child received First Communion?YesNo1st Communion DateChurch (include city)Has this child received First Penance?YesNo1st Penance DateChurch (include city)Would you like to register another new student?YesNoNew Student 2New Student 2 NameGrade(Entering September 2021)Date of Birth(MM/DD/YYYY)AllergiesPlease note any food or medical allergies that we need to be aware of.Has this child been baptized?YesNoBaptism DateChurch (include city)Has this child received First Communion?YesNo1st Communion DateChurch (include city)Has this child received First Penance?YesNo1st Penance DateChurch (include city)Would you like to register another new student?YesNoNew Student 3New Student 3 NameGrade(Entering September 2020)Date of Birth(MM/DD/YYYY)AllergiesPlease note any food or medical allergies that we need to be aware of.Has this child been baptized?YesNoBaptism DateChurch (include city)Has this child received First Communion?YesNo1st Communion DateChurch (include city)Has this child received First Penance?YesNo1st Penance DateChurch (include city)Would you like to register another new student?YesNoNew Student 4New Student 4 NameGrade(Entering September 2020)Date of Birth(MM/DD/YYYY)AllergiesPlease note any food or medical allergies that we need to be aware of.Has this child been baptized?YesNoBaptism DateChurch (include city)Has this child received First Communion?YesNo1st Communion DateChurch (include city)Has this child received First Penance?YesNo1st Penance DateChurch (include city)Consent* I agree to the Church of the Holy Family privacy policy.The Church of the Holy Family Privacy Policy can be found here. https://holyfamilyendwell.com/privacy-policy/Note to Loretta:If you have additional children to register, please enter child information here.CommentsThis field is for validation purposes and should be left unchanged.
