St Mary Catechism Registration

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Registration year 2023-2024

Email *

Full Name of child *

Birthday *

YYYY

Grade (2023/2024 School Year) *

Home Address

Mailing Address (If different from above)

Email Address *

Primary Phone *

Alternate Phone

Father's Full Name

Father's Religion

Mother's Full Name

Mother's Religion

Sacraments child has received and when (year or date)

Baptism, Reconciliation, Eucharist, Confirmation

Emergency Contact Name and Phone Number

Allergies and/or medical conditions we should be aware of *

Photos and videos are taken for promotional purposes related to St. Mary Catholic Church programs. Pictures may appear in various media outlets such as our website, Facebook page and Clipper newspaper. Do you allow your child to be included in these photos and videos? *

yes

Notice of Privacy and Confidentiality:

The information requested on this form will be treated with confidentiality and only used by teachers and administrators to administer the catechism program; et: to provide books, supplies, and teaching services, to facilitate communication with families and to maintain church records. By submitting this form, you are agreeing to the above Privacy and Confidentiality Agreement.

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