Saint Vincent CFF, YM and Sacramental Prep 2019-2020

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Online Registration Form

Email *

Family Name *

Home Parish *

Parents' /Guardians' Information

Father/Guardian First and Last name *

Father/Guardian Phone Number *

Father/Guardian Email Address

Father/Guardian Address *

Fathers/Religion *

Mother/Guardian First and Last name *

Mother/ Guardian Phone Number *

Mother/Guardian Email *

Mother/Guardian Address *

Mother/Guardian Religion *

Emergency Contact Name (Not Parent) *

Emergency Contact Phone Number (Cell Preferred) *

Child Information

Please complete one form for each child

First Name *

Last Name *

Choose your Child's Program(s) *

Pre-K to 5th Grade Sunday Morning Children's Faith Formation

6th to 8th Grade Sunday Night Middle School Youth Ministry

9th to 12th Grade Sunday Night High School Youth Ministry

Once Per Month Family Program K to 8th Grade

Required

Select if your chlid is receiving a Sacrament this Year

First Reconciliation/ Eucharist

Confirmation

Rite of Christian Initiation of Children

Clear selection

School Attending *

Grade *

Pre-K

Kindergarten

1st Grade

2nd Grade

3rd Grade

4th Grade

5th Grade

6th Grade

7th Grade

8th Grade

9th Grade

10th Grade

11th Grade

12th Grade

Required

Date of Birth *

YYYY

Date of Baptism

YYYY

Church of Baptism

Date and Places of First Penance/Communion/Confirmation

Special Needs/Allergies

Photographic Release

A parent/guardian signature is necessary if the subject is under age 18.
I hereby grant to the Diocese of Greensburg, Pennsylvania, and its respective licensees, successors and assigns the right and permission, with respect to those photographs taken of me or the minor named below on whose behalf I am signing and with respect to any printed or electronic matter in connection therewith to do the following:
1. to include such photographs on the Saint Vincent Basilica Parish website for advertising purposes
2. to use my name or the name of the minor on whose behalf I am signing in connection with the foregoing.
I hereby release, discharge and agree to indemnify and hold harmless the Diocese of Greensburg and its legal representatives, licensees, successor and assigns from all claims and demands whatsoever arising out of or in connection with the forgoing and waive any right to inspect or approve the same.

Signature of Parent/Guardian *

Date *

YYYY

Name and Address *

I hereby certify that I am the parent of the minor under the age of 18 named below and hereby consent on behalf of said minor pursuant to the terms set forth in this Photographic Release including, without limitation, the release, discharge and hold harmless provisions thereof.

Name of child *

Please pay for child(ren)'s Faith Formation program(s) and Sacramental Preparation at our parish online giving site basilicaparishstv.org/giving or you may mail a check to the parish office c/o Faith Formation.

Parishioner child(ren) enrolled in CFF: 1 - $30 , 2 - $40, 3 or more - $65
Non-parishioner child(ren) enrolled in CFF: 1 - $40, 2 - $50, 3 or more - $75
Child(ren) enrolled in Middle School Youth Ministry: $20
Child(ren) enrolled in 1st Reconciliation/Communion prep: $20 each
Child(ren) enrolled in Confirmation prep: $10 each

If you are experiencing financial difficulties, please contact Mrs. Bridget DiVittis at 724-539-8629 x 16 regarding scholarships or payment arrangements. NO CHILD WILL BE TURNED AWAY FROM FAITH FORMATION BECAUSE OF FINANCIAL CHALLENGES.

How do you plan to pay? *

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Other:

Payment

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https://basilicaparishstv.weshareonline.org/ws/opportunities/FormationRegistration2019-2020

A copy of your responses will be emailed to the address you provided.

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