2008-2009 Faith Formation Registration Form

Quad Parish Faith Formation Registration 2008-2009

936 9th Street - Green Bay, WI - 54304 - 920-497-7042

Serving Annunciation, St. Joseph, St. Jude and St. Patrick Parishes

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Faith Formation

Family Registration

Family Last Name:

Parish Where You Are a Member Other:

Language spoken in home if other than English:

Children live with (select one): Both Parents: ; Mother: ; Father:; Other: (Other: ()

Mailings should be sent to (select one): Both Parents: ; Mother: ; Father:; Other: (Other: ()

Family Mailings Address:

City: Zip:

Email Address: Home Phone:

Father's Name:

Address if different than above:

City: Zip:

Dad's Work Phone: Check if OK to call

Dad's Cell Phone:

Marital Status: Religion:

Mother's Name:

Address if different than above:

City: Zip:

Mom's Work Phone: Check if OK to call

Mom's Cell Phone:

Marital Status: Religion:

Volunteer Opportunities

Throughout the Faith Formation year, many volunteers are needed to make our program a success. If you are available to help with one of the following areas please check the box and we will contact you with further information.

Teach a Class (Grade ) Drive/Chaperone Service Events

Classroom Aid Children's Liturgy

Classroom Substitute Hall Monitor

Baking/Snacks Youth Ministry Events

Other:

Serve on Faith Formation Committee (meets the first Tuesday of each month from 6:30 -7:30pm)

Videotaping and Still Photographs

Video and still photographs may be taken during the 2008-2009 Faith Formation year. This authorization form constitutes permission from my child's participation in the videotape and/or still photographs, which may be used for future educational, exhibition and promotional efforts, including the Quad-Parishes website and bulletin. A Promotional/Media release form is available in the Quad-Parish Faith Formation office for parents who do not wish to give consent to use the name, portrait or other likeness of their children to the Quad-Parish Faith Formation Center. I have read and understand the above statement

Student Registration

Please fill out the following sections for each student. Additional students may be added at the end of this page. Tuition is $45.00 per student with a family tuition cap of $135.00. An additional Sacramental preparation materials fee of $50.00 is added for all students in grades 2 and 11. Area Special Religious Education is available for students with cognitive disabilities. Contact the Faith Formation office for more information (Email Faith Formation Office here) or call 920-497-7042

1. Student Name (First, Middle Initial, Last)

Male/Female School Attending Grade in Fall 2008

Date of Birth

Baptism Date/Place:

Check if Received: Reconciliation Eucharist

Tuition ($45.00) + Additional Fee For Sacrament Years: Grade 2 ($50.00); Grade 11 ($50.00)

(Please check appropriate box)

2. Student Name (First, Middle Initial, Last)

Male/Female School Attending Grade in Fall 2008

Date of Birth

Baptism Date/Place:

Check if Received: Reconciliation Eucharist

Tuition ($45.00) + Additional Fee For Sacrament Years: Grade 2 ($50.00); Grade 11 ($50.00)

(Please check appropriate box)

3. Student Name (First, Middle Initial, Last)

Male/Female School Attending Grade in Fall 2008

Date of Birth

Baptism Date/Place:

Check if Received: Reconciliation Eucharist

Tuition ($45.00) + Additional Fee For Sacrament Years: Grade 2 ($50.00); Grade 11 ($50.00)

(Please check appropriate box)

4. Student Name (First, Middle Initial, Last)

Male/Female School Attending Grade in Fall 2008

Date of Birth

Baptism Date/Place:

Check if Received: Reconciliation Eucharist

Tuition (No Charge) + Additional Fee For Sacrament Years: Grade 2 ($50.00); Grade 11 ($50.00)

(Please check appropriate box)

Other Students Name (First, Middle Initial, Last) Sacramental Fees (Grade 2; Grade 11)

5. Grade 2: ($50.00); Grade 11 ($50.00)

6. Grade 2: ($50.00); Grade 11 ($50.00)

7. Grade 2: ($50.00); Grade 11 ($50.00)

8. Grade 2: ($50.00); Grade 11 ($50.00)

9. Grade 2: ($50.00); Grade 11 ($50.00)

Total Tuition & Sacramental Fees: $

Choose a Payment Plan Below: (Checks can be made payable to Faith Formation Tuition)

Paying in full at time of registration

Two Equal payments of

Three Equal payments of

No Child is turned away because of an inability to pay. Please complete the following: I am requesting financial assistance in the amount of $ because of

I accept the policies of the Religious Education/Youth Ministry Programs and understand that I am responsible for the tuition and Sacramental fees above.

your email address:

EMERGENCY AUTHORIZATION

Please fill-out the following Emergency Authorization Information:

In case of an accident or serious illness while in the Faith Formation building, and if we as parents

are unable to be reached, I hereby authorize the above named Religious Education and Youth

Ministry Program staff to call the physician listed below and to follow his or her instructions for

the child or children here named. If this physician is unable to be contacted, the staff and their

assistants may make whatever arrangements are deemed necessary.

Emergency Contact Person other than Parent:

Relationship to the Family:

Phone Number:

Cell Phone Number:

Remarks and/or Special Instructions

Thank you