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YOUTH FAITH FORMATION REGISTRATION
2015-2016
Date : ______
FAMILY NAME : ______
ADDRESS : ______
HOME PHONE : ______
FATHER STEPFATHER/GUARDIAN
Name : ______
Occupation : ______Religion : ______
Date of Birth : ______
Work Phone : ______
Cell Phone : ______
Email Address : ______
Marital Status : ______
Has Custody : Yes No Yes No
MOTHER STEPMOTHER/GUARDIAN
Maiden Name : ______
Occupation : ______
Religion : ______
Date of Birth : ______
Work Phone : ______
Cell Phone: ______
Email Address : ______
Marital Status: ______
Has Custody : Yes No Yes No
STUDENT INFORMATION
Name : ______
Date of birth : ______City/State of Birth ______
Male Female
2015 Fall grade : ______School :______
Will attend : Sunday Home program
SACRAMENTAL INFORMATION:
Yes No If Yes, Date Church City/State
Baptism : ______
Reconciliation : ______
Communion : ______
Confirmation : ______
Does your child have any learning or medical conditions that would affect classroom work, participation or behavior?
Yes No
If yes, please explain : ______
______
Grades attended in Catholic school : ______
Grades attended in parish religious education program : ______
Name of school/ parish attended: ______
EMERGENCY CONTACT :
(other than persons listed on the form)
______
Relationship to student : ______
Phone : ______
Address : ______
Will you give this person permission to take your child(ren) off property?
Yes No
FEES: Faith Formation Fees for year 2014-2015
$30 for 1 child $40 for 2 or more $20 extra for Sacrament
AMOUNT PAID :
$______ Cash Check # ______
Payment received by : ______
Date : ______
Thank you!
PROMOTIONAL MEDIA RELEASE
During the Faith Formation Program year, St Vincent de Paul Parish may participate in videotape, motion picture, audio recording or still photograph productions that involve the use of students’ names, likenesses or voices. Such productions may be used for educational or exhibition purposes by St. Vincent de Paul Parish in perpetuity and may be copied, copyrighted, edited and distributed by St. Vincent de Paul Parish in perpetuity unless said consent is revoked in writing.
News media, including representatives of television, radio, newspapers and magazines, also often are permitted on parish property and may takes notes, still, photos, sound recordings and/or moving pictures that may include your child. These items may appear or be used in news or feature stories by print, television or radio media.
You have the right to object to the use of your child’s name, picture or voice in these productions and may do so by completing the form below and returning to the St. Vincent de Paul Parish Faith Formation office.
(Complete for each child )
I/We, the undersigned , do/do not hereby consent that St. Vincent de Paul Parish may use the name,
(circle one)
portrait, or other likeness of my child for bulletin boards, websites, news releases, media and promotional activities. This consent is renewed at the beginning of each Faith Formation program year.
Student’s Name : ______Date of birth : ______
______
Father or Legal guardian’s Name (print) Signature/Date
______
Mother or Legal guardian’s Name (print) Signature/Date
REGISTRATION COMMITMENT
WELCOME to our new Faith Formation year! Thank you for being a part of our faith family and allowing us to share with your children our love of Jesus and His church.
By signing this commitment to register my child/children for the Youth Faith Formation program at
St. Vincent de Paul Parish, I agree to abide by the following policies:
1. All families wishing to enroll their children in the St. Vincent de Paul Faith Formation program
must be registered members of the parish.
2. Unless the child was baptized at St. Vincent de Paul , a copy of the child/children’s Baptismal
Certificate must be provided to the Faith Formation office.
3. In joint custody cases, a letter from the other parent giving their permission for the
child/children to attend faith formation classes and sacrament programs must be provided.
4. Students transferring into St. Vincent de Paul’s Faith Formation program must provide a letter
of attendance from their previous parish program or catholic school.
5. Regular attendance is important. When my child is absent, I will make every effort to call the
faith formation office.
6. Children’s envelopes are available in the faith formation office or in their classes at the new
year.
7. Before starting in a sacrament preparation course, students must have attended classes
regularly for one year immediately prior to the preparation year for First Eucharist or
Confirmation.
8. Discipline : The main rule is to respect ourselves, our catechists and aides, our fellow students
and church property. If it is violated : 1st time=sent to office, 2nd time=parents are called,
3rd time=parents are asked to accompany them to next class
9. Fees: Regular or home program: $30.00=1 child, $40.00=2 or more children and $20 extra for the
Sacrament year.
Please check if you are able to assist in some areas of the youth faith formation:
_____ Catechist _____ Substitute catechist _____ Office _____ Security
Signature : ______Date : ______
Our class times are 10:15-11:45am every Sunday , September-May except on holidays for all grade levels. We begin our assembly for the whole family with coffee, juice, snacks at the Fr. Farrell Hall
at 10:15.
All children are checked in and out for security purposes. We thank you for your cooperation.
SACRAMENT INFORMATION FORM
Please check the Sacrament(s) you are requesting :
Baptism Reconciliation First Communion Confirmation
Profession of Faith ( for non-Catholic Baptisms)
Legal Name : ______
(Use proper name, no nickname please)
Address : ______
Home phone : ______Cell phone : ______
Date of Birth : ______Age : ______Grade : ______
City & State you were born : ______
BAPTISM INFORMATION
Please attach a copy of the baptism certificate to this form if not baptized at St. Vincent de Paul.
If baptized here, please provide the month and year , and we will verify our records : ______
If baptized at other church and you do not have a copy, please provide us with the following information and we will help you locate.
Date of Baptism : ______
Name of church : ______
Address : ______
City & State : ______
Father’s full name : ______
Mother’s full maiden name : ______
X______X______
Signature of Catholic parent –both parents are required to sign if the parents do not live in same household.
(for those under 21 years of age)
FAITH FORMATION OFFICE INFORMATION
St. Vincent de Paul Church
Address : 4843 Mile Stretch Dr, Holiday , FL 34690
Phone : (727)938-1974 ext 108/ 109
Fax : (727) 938-1975
JANE ETZEL- Director of Religious Education
(727) 938-1974 ext 108
ROSEMARIE SCORDIMAGLIA – Youth Director
(727) 938-1974 ext 109
(Please keep this page for your reference)