St. Joseph's Faith Formation/Confirmation Registration Form for 2017-2018
SCHEDULES: ARE FOUND ON OUR PARISH WEBSITE - HOMEPAGE - CLICK ON LINK TO PRINT - ALL AGES ARE ON ONE SCHEDULE FOR EASE.

Disclaimer: Some dates and forms to be turned in will be mentioned in this form. You will receive an email within 3-5 business days of completing this registration with all the information for your records.

Children's Church/First Communion/First Reconciliation Program:
PreK-2nd Grade held during Sunday 10:30AM Mass - October thru April 2018

Release Time:
3rd-5th Grade held alternating Wednesday Afternoons 12:50-5pm - October thru April 2018

Grade 6-11 Faith Formation:
Held Wednesdays 7-8:30pm - 3x Month, October thru April 2018 - these sessions include preparation for Confirmation in the Fall of the youth's Junior Year.

For this Registration you will need:
1) Medical Insurance card(s)

Email address *
Parent's Information
Parent/Guardian 1's First and Last Name *
Your answer
Parent/Guardian 2's First and Last Name
Your answer
Home Phone Number
(###) ###-###
Your answer
Parent 1's Phone Number *
(###) ###-###
Your answer
Parent 2's Phone
(###) ###-###
Your answer
Mailing Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Valid Email Address *
Important information will be sent to this email concerning the Faith Formation/Confirmation Program including program details, important dates and event information.
Your answer
Confirm Email Address *
Your answer
How would you like to volunteer as a parent? *
Please check all that apply. Checking any of these boxes does NOT commit you to this volunteer service every week. A schedule can be arranged.
Required
Are you Safe Environment trained through the Diocese of Duluth (Safe Haven) *
Youth Safe Environment Information
As part of our on-going commitment to ensure the safety of your child(ren), safe environment programming is a part of our religious education program. Students are not required to attend but they and their parents should understand the importance of this program as part of their education about boundaries, appropriate interactions between adults and minors and related personal safety issues. This should not be considered an optional program; students that cannot attend should have a valid reason for their absence. The presumption is that every child will participate in the lessons. Parents may choose to excuse their child from the program. This can be done by initialing the below waiver statement.

Circle of Grace: Each year during one scheduled religious education class time, we provide age appropriate training for our parish youth to help ensure their personal safety through education. Our goal is to prevent all forms of child victimization by teaching youth how to recognize, interrupt and report inappropriate situations before abuse occurs. This curriculum is used Diocesan wide and more information can be found at: www.dioceseduluth.org/Sa. More information can be provided to you by contacting your Faith Formation Director.

Do you give your approval to allow your child to participate in Circle of Grace Safe Environment Session this year? *
If "No", then please read and initial the below statement/waiver
Safe Environment Training Waiver: My/our child will not be attending Safe Environment training provided by the parish.
Your answer
PARENT/LEGAL GUARDIAN PERMISSION SLIP AND INDEMNITY AGREEMENT
PARENTS OF YOUTH IN GRADES 6 THRU 12 — PLEASE READ AND FILL OUT INFORMATION BELOW:
Below you will find a ‘blanket’ permission slip for service or social outings and events that may be held off campus for your 6th thru 12th grade student.
Specific Information will be provided to you via email or handed out to your son/daughter in advance of any activity.

Please fill out information below so that we have a current permission slip on file for your son/daughter to attend events held off of our parish campus.

Your son/daughter, ward is eligible to participate in a school/parish sponsored activity that requires permission. This activity will take place under the guidance and supervision of employees/volunteers from St. Joseph’s Catholic Community_(parish/school).

A brief description of the activity is as follows: Youth Related Activities for 2016-2017 Faith Formation Programs- Gr. 6--12
TYPE OF ACTIVITY: Varies
DESCRIPTION OF ACTIVITY: Varies
DATE AND TIME OF ACTIVITY: Varies – parents will be provided information before event via email/phone call if no email address given.
METHOD OF TRANSPORTATION (IF APPLICABLE): Personal Vehicles/Walking
STUDENT COST (IF APPLICABLE): Varies

I consent to the participation of my child/ward in the above named activity. In consideration for my child/ward's participation, I agree to reimburse and indemnify the above named parish/school (understood to include the Diocese of Duluth) for all reasonable legal and court fees incurred by parish/school in defending a lawsuit that I or my child/ward may bring against the parish/school which relates to the above named activity if the parish/school is found not legally liable by the courts and prevails in the lawsuit. If the parish/school is found liable for the injuries sustained by child/ward, this paragraph will not apply. I certify that I have an understanding of this agreement and the risks and hazards associated with the activity described above that my child/ward will be participating in. I further understand that I had the opportunity to fully discuss this agreement with a representative of the parish/school to clarify any concerns or questions about the activity or this agreement that I may have had.

Please Read the above statement and Initial *
If you do not have children in 6th grade or above, just type "N/A"
Your answer
May we text your Grade 6-12 student(s) about youth group events and information *
If "yes" your child will receive text information pertinent to the Faith Formation Program Events.
EMERGENCY MEDICAL TREATMENT
Name and Phone of Emergency Contact *
Your answer
In the event of an emergency, I give permission to transport my child/ward to a hospital for emergency medical treatment. I wish to be advised prior to any further treatment by the hospital or doctor. *
Medical Insurance Company *
Your answer
Policy Number *
This information will not be shared with anyone. It is simply held in case of an emergency - If registering more than one child and policy numbers are different for each child., please identify child by name in front of account number.
Your answer
Please furnish medical information about your child/ward which may be pertinent to his or her participation in the activities on the Permission Slip/Indemnity Agreement.
If registering more than one child, please identify child by name and list all pertinent information.
Your answer
Child's Information (List Youngest First)
Please enter YOUNGEST CHILD FIRST and list all additional children in order of YOUNGEST TO OLDEST.
Youngest Child's First Name *
Your answer
Youngest Child's Last Name
Your answer
Youngest Childs Gender *
Youngest Childs Date of Birth *
MM/DD/YYYY
MM
/
DD
/
YYYY
Grade *
Grade will indicate child's Youth Program: PreK-2nd Grade: Children's Church; 3rd-5th Grade: Early Release; 6-8th Grade: Faith Formation; 9-12th Grade: Faith Formation/Confirmation Preparation
Child 1's School:
Your answer
Youth Cell Phone Number (Gr 6-12)
Your answer
At this time are you also registering this child (1)for First Communion for 2017?
If Yes, please provide a copy of your child's Baptism Certificate to Parish Office by 1st Communion PARENT MEETING.
Are you registering more than one child? - If not just scroll down to next Section.
If registering more than one child, please list from YOUNGEST TO OLDEST.
Child 2 Faith Formation Registration (2nd Youngest)
Please list in order of YOUNGEST TO OLDEST. This should be your 2ND Youngest child.
Child 2's First Name (2nd Youngest)
Your answer
Child 2's Last Name (2nd Youngest)
Your answer
Child 2's Gender (2nd Youngest)
Child 2's Date of Birth (2nd Youngest)
MM/DD/YYYY
Your answer
Child 2's Grade (2nd Youngest)
Grade will indicate child's Youth Program: PreK-2nd Grade: Children's Church; 3rd-5th Grade: Early Release; 6-8th Grade: Faith Formation; 9-12th Grade: Faith Formation/Confirmation Preparation
Child 2's School (2nd Youngest)
Your answer
Child 2's Phone Number (2nd Youngest)
123-456-7890
Your answer
At this time are you also registering this child (2) for First Communion for 2017?
If Yes, please provide a copy of your child's Baptism Certificate to Parish Office by 1st Communion PARENT MEETING.
Child 3's Faith Formation Registration (3rd Youngest)
Please list in order of YOUNGEST TO OLDEST. This should be your 3RD Youngest child.
Child 3's First Name (3rd Youngest)
Your answer
Child 3's Last Name (3rd Youngest)
Your answer
Child 3's Gender (3rd Youngest)
Child 3's Date of Birth (3rd Youngest)
MM/DD/YYYY
Your answer
Child 3's Grade (3rd Youngest)
Grade will indicate child's Youth Program: PreK-2nd Grade: Children's Church; 3rd-5th Grade: Early Release; 6-8th Grade: Faith Formation; 9-12th Grade: Faith Formation/Confirmation Preparation
Child 3's School:
Your answer
Child 3's Phone Number (3rd Youngest)
123-456-7890
Your answer
At this time are you also registering this child (3) for First Communion for 2017?
If Yes, please provide a copy of your child's Baptism Certificate to Parish Office by 1st Communion PARENT MEETING.
Child 4's Faith Formation Registration (4th Youngest)
Please list in order of YOUNGEST TO OLDEST. This should be your 4Th Youngest child.
Child 4's First Name (4th Youngest)
Your answer
Child 4's Last Name (4th Youngest)
Your answer
Child 4's Gender (4th Youngest)
Child 4's Date of Birth (4th Youngest)
MM/DD/YYYY
Your answer
Child 4's Grade (4th Youngest)
Grade will indicate child's Youth Program: PreK-2nd Grade: Children's Church; 3rd-5th Grade: Early Release; 6-8th Grade: Faith Formation; 9-12th Grade: Faith Formation/Confirmation Preparation
Child 4's School (4th Youngest)
Your answer
Child 4's Phone Number (4th Youngest)
123-456-7890
Your answer
At this time are you also registering this child (4) for First Communion for 2017?
If Yes, please provide a copy of your child's Baptism Certificate to Parish Office by 1st Communion PARENT MEETING.
Child 5's Faith Formation Registration (5th Youngest)
Please list in order of YOUNGEST TO OLDEST. This should be your 5TH Youngest child.
Child 5's First Name (5th Youngest)
Your answer
Child 5's Last Name (5th Youngest)
Your answer
Child 5's Gender (5th Youngest)
Child 5's Date of Birth (5th Youngest)
MM/DD/YYYY
Your answer
Child 5's Grade (5th Youngest)
Grade will indicate child's Youth Program: PreK-2nd Grade: Children's Church; 3rd-5th Grade: Early Release; 6-8th Grade: Faith Formation; 9-12th Grade: Faith Formation/Confirmation Preparation
Child 5's School
Your answer
Child 5's Phone Number
123-456-7890
Your answer
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