Sacramental Preparation Second Year
You will only fill out this registration form if your child has successfully completed their first year of Religious Formation at Shepherd of the Valley Catholic Church, or were enrolled in Sacred Heart School the prior year, or had successfully completed a year of faith formation in another Catholic church and have a letter of recommendation from the Director of Religious Education or Pastor of that Church.  Your child must be 7 years old at the time of receiving First Holy Communion and have had received the sacrament of baptism and will need to provide a copy to Joyce Marks. You will need to co-register into religious formation "A Family of Faith" which meets on Sundays if you are not currently going to Sacred Heart Catholic or Saint Mary's Catholic School.
 Schedule and program information is on our website: shepherdcatholic.com 
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Email *
First Child's Name *
Grade Level *
Date of Birth *
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DD
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Place of Birth (City, State) *
Place of Baptism (Church, City, State) *
Date of Baptism *
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DD
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Parent Cell Phone *
Parent Email *
Fathers Full Name
Mother's Full Maiden Name *
Child(ren) Home Address *
Grade Level *
Children live with whom *
In case of illness, accident or emergency to the student(s) named above, the Archdiocese of Portland and its representatives are authorized to proceed as indicated below in order of desired action I wish you to take. ( Add Mother, Father, and other person, Day Phones, and which Hospital you would like us to take them to in case of injury or emergency)   *
Second Child's Name
Date of Birth
MM
/
DD
/
YYYY
Place of Birth (City, State)
Place of Baptism (Church, City, State)
Date of Baptism
MM
/
DD
/
YYYY
Grade Level
Second Child's Date of Birth
MM
/
DD
/
YYYY
Second Child's Place of Birth (City, State)
Place of Baptism (Church, City, State)
Date of Baptism
MM
/
DD
/
YYYY
Parent Cell Phone
Parent Email
Fathers Full Name
Mother's Full Maiden Name
Child(ren) Home Address
In case of illness, accident or emergency to the student(s) named above, the Archdiocese of Portland and its representatives are authorized to proceed as indicated below in order of desired action I wish you to take. ( Add Mother, Father, and other person, Day Phones, and which Hospital you would like us to take them to in case of injury or emergency)  
Is there any medical condition or special needs that your child has that you think we should know about, so we can keep your child safe or provide a more comfortable environment for them? (If you do, Joyce Marks will be in contact with you for more specific guidance from you)
Allergies
Is child presently on any medications? If so, state name, dosage, reason for drug and prescription physician.
Name of Medical Insurance Company
Group or I.D. Number
I authorize the Archdiocese of Portland and its representative to use their judgment in determining emergency care and procedures for my child.  I also understand and agree that the Archdiocese assumes no financial obligation for expense incurred in carrying out emergency procedures and/or emergency transportation. Please check the box to electronically sign *
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