Catechesis of the Good Shepherd - Registration 2016-2017
"Jesus said, I am the good shepherd. I know my own and my own know me, just as the Father knows me and I know the Father. And I lay down my life for the sheep." -John 10:14-15

Contact person: Nathan Wigfield
Phone: 412-661-3100
Cell: 724-998-2099
Email: nwigfield@straphaelpgh.org

We are registered parishioners at:
If you answered other above, please list the name of the parish.
Your answer
Our child/ren are registered in the Faith Formation program at St. Raphael
We are registering for:
Student Name
Your answer
Student Age/Grade
Your answer
Student Address
Your answer
City, Zip
Your answer
Home Phone Number
Your answer
Parent Email Address
Your answer
Student birth date
MM
/
DD
/
YYYY
Gender
School
Your answer
Date of Baptism
MM
/
DD
/
YYYY
Church of Baptism
Your answer
Church Address
Your answer
Special Needs/Allergies/Requests
Your answer
Has your child attended any previous Religious Education programs?
If you answered yes above, where did your child attend?
Your answer
If you answered yes above, for how many years?
Your answer
Mother's Name (please put maiden name in parenthesis)
Your answer
Mother's Cell
Your answer
If address is different from child, please list here.
Your answer
Father's Name
Your answer
Father's Cell
Your answer
If address is different from child's, please list here.
Your answer
Cost: $40/child or $60/family.
Put payment in offertory marked "CGS registration", or bring to or mail to the Parish Center (1118 Chislet St Pittsburgh PA 15206)
Emergency Contact
Please provide a contact person in the case of a medical emergency while your child is at Catechesis of the Good Shepherd. (Name, phone number, relationship to student)
Your answer
Photo/Video Release - Parent Guardian Consent Form
Please provide a contact person in the case of a medical emergency while your child is at Catechesis of the Good Shepherd. (Name, phone number, relationship to student)
Your typed name here will act as your signature for the photo/video release section.
Your answer
Volunteer Opportunities
I am interested in volunteering for the Catechesis of the Good Shepherd (please check all that apply). Please note: All volunteers must be in compliance with the Clearance Policy established by the Diocese of Pittsburgh.
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