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Saint Mary Confirmation Registration 2020-2021
Please fill out one form for each child in the family that will be enrolled
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* Indicates required question
Email Address
*
Your answer
Are You Registered at Saint Mary
*
Yes
No
Students Last Name:
*
Your answer
Students First Name:
*
Your answer
Students Date of Birth:
*
MM
/
DD
/
YYYY
Gender
Male
Female
Clear selection
Home Address, please include City
*
Your answer
Cell Phone:
*
Your answer
Home Phone
Your answer
Second Email
*
Your answer
Grade in School 2020-21
*
Your answer
School Your Child Will Attend 2020-21
*
Your answer
Father's Name
*
Your answer
Father's Cell
*
Your answer
Mother's Name
*
Your answer
Mother's Cell
*
Your answer
Have there been any gaps in your child's religious education preparation?
*
Your answer
Roman Catholic Baptism
*
Yes
No
A copy of their certificate of Baptism is needed if not Baptized at Saint Mary
*
They were baptized at saint Mary
They were baptized at another church
If baptized at saint Mary, please include an approximate date
Your answer
Have they received the sacrament of first Communion and Reconciliation
*
Yes
No
Is there any medical information or learning needs we should know about?
*
Your answer
Emergency Contact Information (Include Name, Phone and Relationship)
*
Your answer
Primary doctor information, Name and phone number
*
Your answer
Primary doctor information, Name and phone number
*
Your answer
I am interested in Volunteering. New Volunteers will be contacted by Mr Haviland. There are Archdiocese requirements to complete to volunteer. Any questions, contact
phaviland@stmarybg.org
Your answer
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