St. Patrick's Altar Boy Registration and Permission Form, 2019-2020
St. Patrick Altar Server Program
St. Patrick Church
Columbus, Ohio
Diocese of Columbus
stpatrickcolumbus.org
Name/Description of Activity or Event
This form covers all events and activities held at St. Patrick Church and sponsored by the St. Patrick Altar Server Program from August of 2019 through August of 2020. Separate and shorter registration/permission forms will be used for any events held at locations other than St. Patrick Church.
Date(s)
September, 2019 through September, 2020
Location
St. Patrick Church
280 N. Grant Ave.
Columbus, Ohio 43215
Mode of Transportation
Self-provided
Payment: N/A
There is no annual registration fee.
Mandatory Training Sessions and Dates
Parent/Guardian Information
Name of Parent/Guardian Completing This Form *
This online form must be completed by a parent or guardian and not another person on their behalf.
Your answer
Father/Guardian First Name *
Your answer
Father/Guardian Last Name *
Your answer
Father/Guardian Mobile Phone *
Your answer
Father/Guardian Email Address *
Your answer
Has father/guardian been approved to volunteer with youth by the parish office? *
If interested, or for further info, call the parish office at 614-240-5910.
Mother/Guardian First Name *
Your answer
Mother/Guardian Last Name *
Your answer
Mother/Guardian Mobile Phone *
Your answer
Mother/Guardian Email Address *
Your answer
Has mother/guardian been approved to volunteer with youth by the parish office? *
If interested, or for further info, call the parish office at 614-240-5910.
Mailing Address: Street Number and Name *
Your answer
Mailing Address: City *
Your answer
Mailing Address: Zip Code *
Your answer
Would you be willing to share ONLY your city and zip code with other families in the altar server program? *
Due to the wide geographic dispersal of our families, it's often helpful (especially for new families) to know which families live nearby.
Would you like to be added to the Altar Boy Families location map? *
This means sharing your full address only with those families who opt in.
Email Address to Share on the Altar Server Roster *
You may list more than one address, if desired.
Your answer
Phone Number to Share on the Altar Server Roster *
Sharing a phone number is required because email is sometimes insufficient for finding substitutes.
Your answer
Medical Insurance Name *
Your answer
Medical Insurance Policy Number *
Your answer
Medical Insurance Member's Name *
Your answer
Medical Insurance Phone Number *
Typically found on back of insurance card
Your answer
Family Doctor Name *
Your answer
Family Doctor Phone Number *
Your answer
Emergency Contact Name *
In case a parent/guardian can't be reached.
Your answer
Emergency Contact Phone Number *
In case a parent/guardian can't be reached.
Your answer
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