BCCC Faith Formation Registration
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1. Child's Full Name *
Your answer
2. Date and place of birth
Your answer
3. Gender
Column 1
Female
Male
4. Age *
Your answer
5. Grade *
Your answer
6. Was your family registered for Faith Formation last year? *
7. Child's primary address *
Your answer
8. City *
Your answer
9. Home phone *
Your answer
10. Cell phone
Your answer
11. Email
Your answer
12. Custodial parent last name *
Your answer
13. Father's name *
Your answer
14. Mother's maiden name
Your answer
15. Father's religion if not Catholic
Your answer
16. Mother's religion if not Catholic
Your answer
17. Check here if parents live in separate households
18. Father's work place and phone number
Your answer
19. Mother's work place and phone number
Your answer
20. If not being registered by a parent: Contact Name
Your answer
21. If not being registered by a parent: Relationship
Your answer
22. If not being registered by a parent: Address and phone
Your answer
23. Emergency Contact Person in case parents cannot be reached: Name, phone, relationship
Your answer
24. Place where child was baptized: If not baptized at Sacred Heart, St. Ann or Holy Name, please bring a copy of the baptismal certificate
Your answer
25. In which parish is the family registered?
26. If not registered, please explain why
Your answer
27. Is this child in need of any of these sacraments
28. Known allergies, health problems, learning disabilities or any family situations our staff should be aware of. This information will be kept confidential.
Your answer
29. Present medications
Your answer
30. Parents of child are:
Information for parents who live in separate households:
31. Are both parents interested in receiving information from our parish office?
32. Primary custodial parent name
Your answer
33. Primary custodial spouse or household partner name
Your answer
34. Non custodial parent name
Your answer
35. Non custodial spouse or household partner name
Your answer
36. Non custodial parent address
Your answer
37. Non custodial parent phone
Your answer
38. Please explain custodial arrangements
Your answer
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