Family Faith Formation

Child's Full Name REQUIRED Please fill out this field. Please enter valid data.

Date of Birth REQUIRED Please fill out this field. Please enter valid data.

Gender REQUIRED Female Male Please fill out this field.

Class Level REQUIRED K 1st 1st Communion 3rd 4th 5th 1st Year Confirm. 2nd Year Confirm. Please fill out this field.

Father's Name REQUIRED Please fill out this field. Please enter valid data.

Father's Religion REQUIRED Please fill out this field. Please enter valid data.

Father's Cell Number REQUIRED Please fill out this field. Please enter valid data.

Mother's Name (plus Maiden) REQUIRED Please fill out this field. Please enter valid data.

Mother's Religion REQUIRED Please fill out this field. Please enter valid data.

Mother's Cell Number REQUIRED Please fill out this field. Please enter valid data.

Guardian's Name & Religion (if applicable) Please enter valid data.

Guardian's Cell (if applicable) Please enter valid data.

Mailing Address REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Email REQUIRED Please fill out this field. Please enter an email address.

Sacraments Received REQUIRED Baptism Reconciliation 1st Holy Communion Confirmation Please fill out this field.

Date of Baptism REQUIRED Please fill out this field. Please enter valid data.

Parish, City & State REQUIRED Please fill out this field. Please enter valid data.

Allergies or Medical Conditions REQUIRED Please fill out this field. Please enter valid data.

Emergency Contact Name REQUIRED Please fill out this field. Please enter valid data.

Relationship REQUIRED Please fill out this field. Please enter valid data.

Cell Phone Number REQUIRED Please fill out this field. Please enter valid data.

Registration Fee - $25 per child REQUIRED Mail Payment Bring payment to office Please fill out this field.

Class Type Preference REQUIRED In person classes (recommended) Online Classes Please fill out this field.

Questions, Concerns or Comments?

How are you able to help this year? Catechist Aid Substitute Catechist Volunteer Aide at Sacramental Retreats Provide Snacks Donate Supplies

HOLY NAME
CATHOLIC CHURCH