2021-2022 Youth Faith Formation Registration

Student's Name*

First, Last
Student's Date of Birth*

Month/Day/Year
Student's Grade 2021-2022 School Year*
Student's Address*

Street, City, Zip
Student's Home Phone*
Student Cell
Student Email
Parent #1 Name*
Parent #1 Address

If different from student.
Parent #1 Cell*
Parent #1 Email*
Parent #1 Religion
Parent #2 Name
Parent #2 Address

If different from student.
Parent #2 Cell
Parent #2 Email
Parent #2 Religion
Student's Date of Baptism*
Student's Place of Baptism*

Include church, city, & state
Student's Date of First Eucharist
Mother's Maiden Name*
We need catechists, classroom helpers, and team members for our program to succeed. Please see the volunteer descriptions and indicate in which way you would be interested in helping.
If you are interested in K-6, which grade is your preference?
If you would like to co-lead, is there someone you would like to co-lead with?
Please list any special needs or concerns for the student: