Faith Formation Registration | Mary, Mother of Our Savior Parish

👤

Student Information

Student Name *

Date of Birth *

Street Address *

City *

State *

Zip Code *

City of Birth

Grade *

School

🏠

Parent / Guardian Information

Father's Name

Mother's Name

Mother's Maiden Name

Parent Cell # *

Parent Home Phone #

Parent Email *

ℹ️

Custody & Health Information

Are there any custody issues staff should be aware of?

No Yes

Please briefly describe:

Allergies, Special Conditions, or Learning Needs

Please list any allergies, special conditions or needs your child has in a learning environment. Modification will be determined on an individual basis.

🚨

Emergency Contact

Emergency Contact Name *

Phone # *

Relationship to Student

Alternate Phone #

Authorized Pickup (Grades K–6)

List any others, besides yourself, who are allowed to pick up your child. These people may be asked to show ID.

💧

Baptism

Date of Baptism

Parish

City

State

Zip Code

✝

First Eucharist / Holy Communion

Date of First Eucharist

Parish

City

State

Zip Code

My child is in Grades 3–10 and has NOT received the Sacrament of First Reconciliation or First Eucharist.

Important: If your child was NOT baptized at Our Lady of Lourdes or Our Lady of the Rosary, you must submit a copy of your child's Baptismal Certificate with this registration.

📷

Photo Authorization

Photographs and/or videos of minors are taken periodically for use in parish or diocesan publications and to celebrate your child's participation and accomplishments. By submitting this registration, you are granting permission to Mary, Mother of Our Savior Parish to use photos and videos of your child. If names are used, only your child's first name will be published. Last names will not be used without contacting you and obtaining your permission. You may limit or disallow this by contacting the Faith Formation Coordinator and providing written notice.

Parent/Guardian Name (confirms agreement) *

By entering your name, you confirm all information provided is correct and give photo permission as described above.

🙏

Siblings & Volunteer Interest

Siblings Participating in This Program

Your child is encouraged to assist at Mass — check any that apply:

Altar Server Lector Greeter

I would like to volunteer to help the Faith Formation team as a:

Teacher Substitute Classroom Assistant

Mary, Mother of Our Savior Parish

Grades K–10 Faith Formation Registration

✝ Registration Submitted