Faith Formation Registration
Holy Family Church ~ Latrobe, PA
PreK-6th Grade
2020-2021
Email address *
Child / Youth's Name *
Address *
Home Phone Number *
Cell Phone Number *
Date of Birth *
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DD
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Current Grade *
Parents/Guardians *
Email Address *
Emergency Contact (Name and Phone Number) *
Sacraments: Has your child received Baptism, Reconciliation, First Eucharist, and/or Confirmation? For all applicable, please provide the parish and date. *
Does your child have any medical conditions/learning support needs we should be aware of? *
Please be made aware that there is a $20.00 registration fee for the first child, $15.00 for the second, and $40.00 for 3 or more children. *
Required
Who is authorized to pick child up? (Your child will have to be signed out) *
[PLEASE SIGN] By entering your initials in the box below, you are effectively providing your signature, indicating that all the information on this form is true and accurate, to the best of your knowledge. *
PHOTOGRAPHIC RELEASE LETTER 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 Diocese of Greensburg website and on print material.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 claims and demands whatsoever arising out of or in connection with the foregoing, and waive any right to inspect or approve the same. I hereby certify that I am the Parent and/or Guardian of the above-stated minor under the age of eighteen years, and hereby consent on behalf of said minor to the use of any of the photographs taken of said minor pursuant to the terms set forth in this Photographic release, including, without limitation, the release, discharge and hold harmless provisions thereof. By entering your initials in the box below, you are effectively providing your signature, indicating that all the information on this form is true and accurate, to the best of your knowledge. *
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