2021-2022 Faith Formation, Sacrament, Youth Ministry, & VBS Registration
This form is for anyone enrolling in our Vacation Bible School, Faith Formation Program, and/or those enrolling in the Sacraments of First Reconciliation/First Communion and Confirmation this year. It is also for teens interested in service projects, leadership opportunities, and/or youth group.

Please complete this form in its entirety. One form per child.

Program Fees:
~Family Faith Formation & Catechesis of the Good Shepherd - $60 for one child; $85 for two children; $105 for 3 or more children
~First Reconciliation & First Eucharist - $50 per child
~Confirmation (fee per year) - $25 per child
~VBS - $30 for one child; $60 for two children; $75 for 3 or more children

Payment Options:
1. Pay online here: https://www.kateriirondequoit.org/faith/faith-formation-registration/
2. Mail or drop off a check or exact cash to Faith Formation Office, 445 Kings Hwy S, 14617.  
Please make checks payable to Saint Kateri, with appropriate programs listed in the memo line.

If you are in need financial assistance to cover part of your fee, or have any registration questions contact our office at 585-338-1146
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Email *
Child Last Name *
Child First Name *
Child Middle Name
Child Date of Birth *
Child Place of Birth *
Child Gender *
Child Name of School in the 2021-2022 School Year *
Child Grade in School in 2021-2022 School Year *
Child Name of Location and Last Grade Level of Faith Formation or Catholic School Completed *
Child Sacraments Received: (Baptism, First Communion, First Penance, and/or Confirmation) along with Location and Date where each Sacrament was celebrated. Please provide us with a copy of your child’s Baptismal Certificate if s/he was baptized at a church other than any of the those included in our Saint Kateri Parish. *
Child Special Needs and/or Allergies (please list all below or put "N/A" if not applicable) *
Child Faith Formation, Sacrament, & Youth Ministry Program Options for 2021-2022. Please check all that apply: *
What parish does your family belong to? (Example: Saint Kateri Parish): *
Parent 1 Last Name *
Parent 1 First Name *
Parent 2 Last Name *
Parent 2 First Name *
Mother's Maiden Name - required for Sacrament record keeping *
Primary Phone *
Primary Email Address *
Other Email Address
Street Address *
Town/City *
Zip Code *
Emergency Contact Name (someone other than a parent) *
Emergency Contact Phone *
Name of Health Insurance Company *
Health Insurance Policy Number *
Child's Physician *
Physician Phone Number *
I hereby certify that the above information is correct and give permission for my child to be transported in privately owned vehicles for medical emergencies only.  I give permission for the release of medical records to an attending health care professional in case of injury or illness.  I understand that every effort will be made to contact the parent/guardian first.  If parent/guardian cannot be contacted, I hereby give permission for a qualified physician to secure proper treatment for my child.  I appoint the designated parish Faith Formation facilitator to act on my behalf in authorizing necessary emergency medical, dental, surgical care and hospitalization necessary to protect the child's life and health while she/he is participating in any parish Faith Formation, youth ministry and sacramental preparation sessions.  I give Saint Kateri Parish permission to use pictures and/or videos of my child for the Saint Kateri Parish website, newsletters and bulletins.  Parent/Guardian Signature (Required): *
A copy of your responses will be emailed to the address you provided.
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