JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
St. Joseph/St. Ann Registration form 2021/2022
Please complete and submit one form for each child. ( Kindergarten through 12 grade)
*First Class September 8th
*Children will attend every week on Wednesdays
*Time to be announced at later date
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
By Completing and submitting this form I acknowledge that all information given for this child is correct and up to date.
*
yes
No
By Completing and submitting this form I agree to all behavior, appearance, and liability agreement, That all children are to respect Catechists and helpers and behave with proper conduct at all times.
*
yes
No
Child's Last Name
*
Your answer
Child's First Name
*
Your answer
Child's age
*
Your answer
Child's Birthday
*
MM
/
DD
/
YYYY
Child's Gender
*
Female
Male
Church Child attends
*
St. Joseph
St. Ann
Other:
Required
Child's School he/she attends
*
Your answer
Child's School Grade
*
Choose
K
1
2
3
4
5
6
7
8
9
10
11
12
Child's Religion Grade
*
Choose
K
1
2
3
4
5
6
7
8
9
10
11
12
Child's Emergency Contact number and name
*
Your answer
Child lives with
*
Choose
Mother
Father
Both Parents
Family Member
My child has received the following Sacraments
*
Baptism
1st Communion
Confirmation
None above
Required
Picture release agreement ( I give my permission to use the picture of the child listed above for church purpose only.
*
Yes
No
Dose Child listed above have allergies (If yes please list allergies in box below)
*
yes
No
If YES please list below
Your answer
Parent Information
Fathers full name
*
Your answer
Fathers Mailing Address
*
Your answer
Fathers Contact Number
*
Your answer
Mothers full Maiden name
Your answer
Mothers Mailing Address / Same as above
Your answer
Mothers contact number
*
Your answer
Do you as parents receive Church support envelopes
*
Yes
No
Parents email address
Your answer
Do you have a Facebook page?
*
Yes
No
Are you receiving Facebook / text updates from your child's religion grade. If no please fill the next box.
*
Yes
No
I would like to be added to Private Facebook page for religion grade.
Yes
No
Clear selection
My Facebook name is listed as
Your answer
Legal Guardian Information
If your not the parent but have legal custody of child listed above please fill out information below
Legal Guardian Full name (If not Parent)
Your answer
Legal Guardian Contact numbers ( Home, Work Cell)
Your answer
Legal Guardian Mailing Address
Your answer
Do you as Legal Guardian Receive church envelopes
Yes
No
Clear selection
Parental Authorization ( Check out/Pick up)
Please list two names who are allowed to leave church property with child listed above
#1 Full name and contact number of authorized adult for child listed above
*
Your answer
#1 Relationship to child listed above
*
Your answer
#2 Full name of and number of authorized adult for child listed above
*
Your answer
#2 Relationship to child listed above
*
Your answer
Submit
Page 1 of 1
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
