Family Faith Registration Online

Church of St. Francis Xavier

Religious Education Registration Form 2011-2012

Fee Tuition $75/child / Sacramental Fee $50/child

Fee Tuition and Sacramental Fee must be submitted at the time of registration

Note: A copy of certificate of Baptism is needed for our files for Children who were baptized outside of St. Francis Xavier

*(denotes required field)

Name: *

E-Mail Address: *

Family Name: *

Registration Date: *

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Registered in Parish: *

yes
no.

Home Phone:

Address: *

City: *

Zip: *

Mother’s Name:

Mother’s Religion:

Mother’s Work Phone:

Mother’s Cell Phone:

Mother’s E-mail:

Father’s Name:

Father’s Religion:

Father’s Work Phone:

Father’s Cell phone:

Father’s E-mail:

EMERGENCY CONTACT

Name:

Telephone:

Relationship:

Please, indicate the ministries that you are willing to participate during the year (check):

Mother:

Lector
Eucharistic Minister
Catechist Assistant
Hospitality Minister.

Father:

Lector
Eucharistic Minister
Catechist Assistant
Hospitality Minister.

STUDENT 1

Student Name (First, Middle, Last):

Grade:

Birth Date:

Birth Place:

Sacraments Received:

Baptism
Reconciliation
1st Communion.

BAPTISM INFORMATION

Church:

City State:

Baptism Date:

COMMUNION INFORMATION

Church:

City State:

Communion Date:

Please list any allergies, medical problems, physical or learning disabilities of which we should be aware:

Indicate the ministries that the student is willing to participate during the year:

Lector Hospitality
Minister.

STUDENT 2

Student Name (First, Middle, Last):

Grade:

Birth Date:

Birth Place:

Sacraments Received:

Baptism
Reconciliation
1st Communion.

BAPTISM INFORMATION

Church:

City State:

Baptism Date:

COMMUNION INFORMATION

Church:

City State:

Communion Date:

Please list any allergies, medical problems, physical or learning disabilities of which we should be aware:

Indicate the ministries that the student is willing to participate during the year:

Lector Hospitality
Minister.

STUDENT 3

Student Name (First, Middle, Last):

Grade:

Birth Date:

Birth Place:

Sacraments Received:

Baptism
Reconciliation
1st Communion.

BAPTISM INFORMATION

Church:

City State:

Baptism Date:

COMMUNION INFORMATION

Church:

City State:

Communion Date:

Please list any allergies, medical problems, physical or learning disabilities of which we should be aware of:

Indicate the ministries that the student is willing to participate during the year:

Lector Hospitality
Minister.

Subject: *

Message: *

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