Saint Vincent CFF, YM and Sacramental Prep 2019-2020
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) *
Required
Select if your chlid is receiving a Sacrament this Year
Clear selection
School Attending *
Grade *
Required
Date of Birth *
MM
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DD
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YYYY
Date of Baptism
MM
/
DD
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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 *
MM
/
DD
/
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? *
A copy of your responses will be emailed to the address you provided.
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