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Faith Formation/Catechesis of the Good Shepherd Registration Form

- Parish Life

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- Parent/ Guardian Information
  
  Parent/ Guardian Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Parent/ Guardian First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Parent/ Gauradian Role (i.e. mother, father, grandparent) REQUIRED Please fill out this field. Please enter valid data.
  
  Parent/ Guardian Phone Number Please enter valid data.
  
  Parent/ Gauradian 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.
  
  Parent/ Guardian Email Address REQUIRED Please fill out this field. Please enter an email address.
  
  Parent/ Guardian Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Parent/ Guardian Church Attending REQUIRED Please fill out this field. Please enter valid data.
  
  Child(ren) lives with: (You can check multiple options) REQUIRED Mother & Father Mother Father Mother & Stepfather Father & Stepmother Grandparent Other Please fill out this field.
- Additional Parent/ Guardian Information
  
  Parent/ Guardian Last Name Please enter valid data.
  
  Parent/ Guardian First Name Please enter valid data.
  
  Parent/ Gauradian Role (i.e. mother, father, grandparent) Please enter valid data.
  
  Parent/ Guardian Phone Number Please enter valid data.
  
  Parent/ Gauradian Address Please enter valid data.
  
  City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
  
  Parent/ Guardian Email Address Please enter an email address.
  
  Parent/ Guardian Religion Please enter valid data.
  
  Parent/ Guardian Church Attending Please enter valid data.
  
  Child(ren) lives with: (You can check multiple options) Mother & Father Mother Father Mother & Stepfather Father & Stepmother Grandparent Other
- Payment Information
  
  This year, The cost for one child to attend Faith Formation for is $40 for one child and $15 dollars for every additional child*,unless your child is receiving the sacrament of Confirmation**
  
  Checks can be made out to St. Peter Catholic Church. You can pay in the office, by mail, or online.
  
  *Scholarships are available! No child will be turned away. Let us know if you would like to request any financial assisstance!
  
  I understand the cost for Faith Formation this year. Please select this field.
  
  Would you like to request financial assistance towards Faith Formation? REQUIRED Please fill out this field.
- Child(ren) Information
  
  1 - Child First & Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  1 - Gender REQUIRED Male Female Please fill out this field.
  
  1 - Birth date REQUIRED Please fill out this field. Please enter valid data.
  
  1 - Age REQUIRED Please fill out this field. Please enter valid data.
  
  1 - School attending REQUIRED Please fill out this field. Please enter valid data.
  
  1 - Grade (preK - 8th grade) REQUIRED Please fill out this field. Please enter valid data.
  
  1 - Has your child ever participated in a faith formation program at St. Peter's? REQUIRED Yes! They came to VBS and loved it! Yes! They have been participating of faith formation programs at St. Peter's for a while! Nope! But they have participated in other faith formation programs at other parishes/ churches! Nope! But we are so excited to jump in! Please fill out this field.
  
  1- Tshirt Size Youth Small Youth Medium Youth Large Adult Small Adult Medium Adult Large Adult XL
- 1 - Sacramental Celebration Information
  
  1 - Has your child received the sacrament of Baptism? REQUIRED Yes No Please fill out this field.
  
  1 - Which parish did your child receive the sacrament of Baptism? Please enter valid data.
  
  City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
  
  1 - Has your child received the sacrament of Reconciliation/Confession? REQUIRED Yes No Please fill out this field.
  
  1 - Which parish did your child receive the sacrament of Reconciliation/ Confession? Please enter valid data.
  
  City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
  
  1 - Has your child received the sacrament of First Holy Communion/ First Eucharist? REQUIRED Yes No Please fill out this field.
  
  1 - Which parish did your child receive the sacrament of First Holy Communion/ Eucharist? Please enter valid data.
  
  City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
  
  1 - Has your child received the sacrament of Confirmation? REQUIRED Yes No Please fill out this field.
  
  1 - Which parish did your child receive the sacrament of Confirmation? Please enter valid data.
  
  City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
- 1 - Special Medical/ Educational Needs
  
  Check all boxes that apply: ADD/ADHD Austism Spectrum Behavioral/ Emotional Disorder Hearing Impairment (including deafness) Visual Impairment (including blindness) Orthopedic Impairment Speech or Langauge Impairment Child needs an individual aid in class Child unable to use stairs Developmental Disabilities Reading Difficulties (including dyslexia and dysgraphia) Special Diets
  
  1 - Other health concerns: (e.g. chronic or acute diabetes, epilepsy, hemophilia, asthma etc.) Please enter valid data.
  
  1 - Does you child have any severe allergies? (i.e. peanuts, bees, latex?) REQUIRED Yes No Please fill out this field.
  
  1 - Please list any allergies we should know about: Please enter valid data.
  
  1 - Please list any other comments or concerns regarding your child that will help him/her to be successful in Faith Formation: Please enter valid data.
- Permission and Release
  
  1. By Checking the box below, I give permission for my child to participate in St. Peter Faith Formation and release from all liability and indemnify the volunteers and employees of the Bishop of Columbus individually and as trustee for the Diocese of Columbus, St. Peter parish, and all parishes/schools and their representatives from any and all liability, claims, judgments, cost and expenses, including attorney's fees, arising out of any injury or illness incurred by my child while participating in or traveling to or from the activity and further agree not to bring or prosecute or allow to be brought or prosecuted (including but not limited to prosecution through subrogation) in my name, or on behalf of my child, any claims, lawsuits, or actions against St. Peter Catholic Church, the Diocese of Columbus, volunteers, and employees.
  
  2. I further understand that my child's participation in this activity is purely voluntary and is a privilege and not a right, and that my child, and I, on behalf of my child, agree to my child's participation in St. Peter Faith Formation despite the risks.
  
  I Agree to the above terms and conditions Please select this field.
  
  During Faith Formation, we take pictures that appear on the church website, Facebook page, and newsletter. These are put within these medias without names. Please indicate if this is acceptable or not. REQUIRED Please fill out this field.
- Medical Authorization
  
  In case of an emergency, I understand St. Peter Faith Formation will make every effort to contact me or other designated emergency contact
  
  Emergency Contact REQUIRED Please fill out this field. Please enter valid data.
  
  Emergency Contact Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  However if they cannot reach me or the designated person, I give my permission to call for emergency medical assistance. I release St. Peter Faith Formation and St. Peter Church and volunteer staff, and volunteers from all liability of any kind which may arise from such emergency.
  
  Parent Signature REQUIRED Please fill out this field. Please enter valid data.
  
  Date REQUIRED Please fill out this field. Please enter a date.
- 2 - Child(ren) Information
  
  2 - Child First & Last Name Please enter valid data.
  
  2 - Gender Male Female
  
  2 - Birth date Please enter valid data.
  
  2 - Age Please enter valid data.
  
  2 - School attending Please enter valid data.
  
  2 - Grade (preK - 8th grade) Please enter valid data.
  
  2 - Has your child ever participated in a faith formation program at St. Peter's? Yes! They came to VBS and loved it! Yes! They have been participating of faith formation programs at St. Peter's for a while! Nope! But they have participated in other faith formation programs at other parishes/ churches! Nope! But we are so excited to jump in!
  
  2 - T Shirt Size Youth Small Youth Medium Youth Large Adult Small Adult Medium Adult Large Adult XL
- 2 - Sacramental Celebration Information
  
  2 - Has your child received the sacrament of Baptism? Yes No
  
  2 - Which parish did your child receive the sacrament of Baptism? Please enter valid data.
  
  City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
  
  2 - Has your child received the sacrament of Reconciliation/Confession? Yes No
  
  2 - Which parish did your child receive the sacrament of Reconciliation/ Confession? Please enter valid data.
  
  City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
  
  2 - Has your child received the sacrament of First Holy Communion/ First Eucharist? Yes No
  
  2 - Which parish did your child receive the sacrament of First Holy Communion/ Eucharist? Please enter valid data.
  
  City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
  
  2 - Has your child received the sacrament of Confirmation? Yes No
  
  2 - Which parish did your child receive the sacrament of Confirmation? Please enter valid data.
  
  City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
- 2 - Special Medical/ Educational Needs
  
  Check all boxes that apply: ADD/ADHD Austism Spectrum Behavioral/ Emotional Disorder Hearing Impairment (including deafness) Visual Impairment (including blindness) Orthopedic Impairment Speech or Langauge Impairment Child needs an individual aid in class Child unable to use stairs Developmental Disabilities Reading Difficulties (including dyslexia and dysgraphia) Special Diets
  
  2 - Other health concerns: (e.g. chronic or acute diabetes, epilepsy, hemophilia, asthma etc.) Please enter valid data.
  
  2 - Does you child have any severe allergies? (i.e. peanuts, bees, latex?) Yes No
  
  2 - Please list any allergies we should know about: Please enter valid data.
  
  2 - Please list any other comments or concerns regarding your child that will help him/her to be successful in Faith Formation: Please enter valid data.
- Permission and Release
  
  1. By Checking the box below, I give permission for my child to participate in St. Peter Faith Formation and release from all liability and indemnify the volunteers and employees of the Bishop of Columbus individually and as trustee for the Diocese of Columbus, St. Peter parish, and all parishes/schools and their representatives from any and all liability, claims, judgments, cost and expenses, including attorney's fees, arising out of any injury or illness incurred by my child while participating in or traveling to or from the activity and further agree not to bring or prosecute or allow to be brought or prosecuted (including but not limited to prosecution through subrogation) in my name, or on behalf of my child, any claims, lawsuits, or actions against St. Peter Catholic Church, the Diocese of Columbus, volunteers, and employees.
  
  2. I further understand that my child's participation in this activity is purely voluntary and is a privilege and not a right, and that my child, and I, on behalf of my child, agree to my child's participation in St. Peter Faith Formation despite the risks.
  
  I Agree to the above terms and conditions Please select this field.
  
  During Faith Formation, we take pictures that appear on the church website, Facebook page, and newsletter. These are put within these medias without names. Please indicate if this is acceptable or not. REQUIRED Please fill out this field.
- 3 - Child(ren) Information
  
  3 - Child First & Last Name Please enter valid data.
  
  3 - Gender Male Female
  
  3 - Birth date Please enter valid data.
  
  3 - Age Please enter valid data.
  
  3 - School attending Please enter valid data.
  
  3 - Grade (preK - 8th grade) Please enter valid data.
  
  3 - Has your child ever participated in a faith formation program at St. Peter's? Yes! They came to VBS and loved it! Yes! They have been participating of faith formation programs at St. Peter's for a while! Nope! But they have participated in other faith formation programs at other parishes/ churches! Nope! But we are so excited to jump in!
  
  3 - T Shirt Size Youth Small Youth Medium Youth Large Adult Small Adult Medium Adult Large Adult XL
- 3 - Sacramental Celebration Information
  
  3 - Has your child received the sacrament of Baptism? Yes No
  
  3 - Which parish did your child receive the sacrament of Baptism? Please enter valid data.
  
  City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
  
  3 - Has your child received the sacrament of Reconciliation/Confession? Yes No
  
  3 - Which parish did your child receive the sacrament of Reconciliation/ Confession? Please enter valid data.
  
  City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
  
  3 - Has your child received the sacrament of First Holy Communion/ First Eucharist? Yes No
  
  3 - Which parish did your child receive the sacrament of First Holy Communion/ Eucharist? Please enter valid data.
  
  City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
  
  3 - Has your child received the sacrament of Confirmation? Yes No
  
  3 - Which parish did your child receive the sacrament of Confirmation? Please enter valid data.
  
  City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
- 3 - Special Medical/ Educational Needs
  
  Check all boxes that apply: ADD/ADHD Austism Spectrum Behavioral/ Emotional Disorder Hearing Impairment (including deafness) Visual Impairment (including blindness) Orthopedic Impairment Speech or Langauge Impairment Child needs an individual aid in class Child unable to use stairs Developmental Disabilities Reading Difficulties (including dyslexia and dysgraphia) Special Diets
  
  3 - Other health concerns: (e.g. chronic or acute diabetes, epilepsy, hemophilia, asthma etc.) Please enter valid data.
  
  3 - Does you child have any severe allergies? (i.e. peanuts, bees, latex?) Yes No
  
  3 - Please list any allergies we should know about: Please enter valid data.
  
  3 - Please list any other comments or concerns regarding your child that will help him/her to be successful in Faith Formation: Please enter valid data.
- Permission and Release
  
  1. By Checking the box below, I give permission for my child to participate in St. Peter Faith Formation and release from all liability and indemnify the volunteers and employees of the Bishop of Columbus individually and as trustee for the Diocese of Columbus, St. Peter parish, and all parishes/schools and their representatives from any and all liability, claims, judgments, cost and expenses, including attorney's fees, arising out of any injury or illness incurred by my child while participating in or traveling to or from the activity and further agree not to bring or prosecute or allow to be brought or prosecuted (including but not limited to prosecution through subrogation) in my name, or on behalf of my child, any claims, lawsuits, or actions against St. Peter Catholic Church, the Diocese of Columbus, volunteers, and employees.
  
  2. I further understand that my child's participation in this activity is purely voluntary and is a privilege and not a right, and that my child, and I, on behalf of my child, agree to my child's participation in St. Peter Faith Formation despite the risks.
  
  I Agree to the above terms and conditions Please select this field.
  
  During Faith Formation, we take pictures that appear on the church website, Facebook page, and newsletter. These are put within these medias without names. Please indicate if this is acceptable or not. REQUIRED Please fill out this field.
- 4 - Child(ren) Information
  
  4 - Child First & Last Name Please enter valid data.
  
  4 - Gender Male Female
  
  4 - Birth date Please enter valid data.
  
  4 - Age Please enter valid data.
  
  4 - School attending Please enter valid data.
  
  4 - Grade (preK - 8th grade) Please enter valid data.
  
  4 - Has your child ever participated in a faith formation program at St. Peter's? Yes! They came to VBS and loved it! Yes! They have been participating of faith formation programs at St. Peter's for a while! Nope! But they have participated in other faith formation programs at other parishes/ churches! Nope! But we are so excited to jump in!
  
  4 - T Shirt Size Youth Small Youth Medium Youth Large Adult Small Adult Medium Adult Large Adult XL
- 4 - Sacramental Celebration Information
  
  4 - Has your child received the sacrament of Baptism? Yes No
  
  4 - Which parish did your child receive the sacrament of Baptism? Please enter valid data.
  
  City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
  
  4 - Has your child received the sacrament of Reconciliation/Confession? Yes No
  
  4 - Which parish did your child receive the sacrament of Reconciliation/ Confession? Please enter valid data.
  
  City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
  
  4 - Has your child received the sacrament of First Holy Communion/ First Eucharist? Yes No
  
  4 - Which parish did your child receive the sacrament of First Holy Communion/ Eucharist? Please enter valid data.
  
  City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
  
  4 - Has your child received the sacrament of Confirmation? Yes No
  
  4 - Which parish did your child receive the sacrament of Confirmation? Please enter valid data.
  
  City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
- 4 - Special Medical/ Educational Needs
  
  Check all boxes that apply: ADD/ADHD Austism Spectrum Behavioral/ Emotional Disorder Hearing Impairment (including deafness) Visual Impairment (including blindness) Orthopedic Impairment Speech or Langauge Impairment Child needs an individual aid in class Child unable to use stairs Developmental Disabilities Reading Difficulties (including dyslexia and dysgraphia) Special Diets
  
  4 - Other health concerns: (e.g. chronic or acute diabetes, epilepsy, hemophilia, asthma etc.) Please enter valid data.
  
  4 - Does you child have any severe allergies? (i.e. peanuts, bees, latex?) Yes No
  
  4 - Please list any allergies we should know about: Please enter valid data.
  
  4 - Please list any other comments or concerns regarding your child that will help him/her to be successful in Faith Formation: Please enter valid data.
- Permission and Release
  
  1. By Checking the box below, I give permission for my child to participate in St. Peter Faith Formation and release from all liability and indemnify the volunteers and employees of the Bishop of Columbus individually and as trustee for the Diocese of Columbus, St. Peter parish, and all parishes/schools and their representatives from any and all liability, claims, judgments, cost and expenses, including attorney's fees, arising out of any injury or illness incurred by my child while participating in or traveling to or from the activity and further agree not to bring or prosecute or allow to be brought or prosecuted (including but not limited to prosecution through subrogation) in my name, or on behalf of my child, any claims, lawsuits, or actions against St. Peter Catholic Church, the Diocese of Columbus, volunteers, and employees.
  
  2. I further understand that my child's participation in this activity is purely voluntary and is a privilege and not a right, and that my child, and I, on behalf of my child, agree to my child's participation in St. Peter Faith Formation despite the risks.
  
  I Agree to the above terms and conditions Please select this field.
  
  During Faith Formation, we take pictures that appear on the church website, Facebook page, and newsletter. These are put within these medias without names. Please indicate if this is acceptable or not. REQUIRED Please fill out this field.
- Permission and Release
  
  1. By Checking the box below, I give permission for my child to participate in St. Peter Faith Formation and release from all liability and indemnify the volunteers and employees of the Bishop of Columbus individually and as trustee for the Diocese of Columbus, St. Peter parish, and all parishes/schools and their representatives from any and all liability, claims, judgments, cost and expenses, including attorney's fees, arising out of any injury or illness incurred by my child while participating in or traveling to or from the activity and further agree not to bring or prosecute or allow to be brought or prosecuted (including but not limited to prosecution through subrogation) in my name, or on behalf of my child, any claims, lawsuits, or actions against St. Peter Catholic Church, the Diocese of Columbus, volunteers, and employees.
  
  2. I further understand that my child's participation in this activity is purely voluntary and is a privilege and not a right, and that my child, and I, on behalf of my child, agree to my child's participation in St. Peter Faith Formation despite the risks.
  
  I Agree to the above terms and conditions Please select this field.
  
  During Faith Formation, we take pictures that appear on the church website, Facebook page, and newsletter. These are put within these medias without names. Please indicate if this is acceptable or not. REQUIRED Please fill out this field.
- 5 - Child(ren) Information
  
  5 - Child First & Last Name Please enter valid data.
  
  5 - Gender Male Female
  
  5 - Birth date Please enter valid data.
  
  5 - Age Please enter valid data.
  
  5 - Has your child ever participated in a faith formation program at St. Peter's? Yes! They came to VBS and loved it! Yes! They have been participating of faith formation programs at St. Peter's for a while! Nope! But they have participated in other faith formation programs at other parishes/ churches! Nope! But we are so excited to jump in!
  
  5 - T Shirt Size Youth Small Youth Medium Youth Large Adult Small Adult Medium Adult Large Adult XL
- 5 - Sacramental Celebration Information
  
  5 - Has your child received the sacrament of Baptism? Yes No
  
  5- Which parish did your child receive the sacrament of Baptism? Please enter valid data.
  
  City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
  
  5 - Has your child received the sacrament of Reconciliation/Confession? Yes No
  
  5 - Which parish did your child receive the sacrament of Reconciliation/ Confession? Please enter valid data.
  
  City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
  
  5 - Has your child received the sacrament of First Holy Communion/ First Eucharist? Yes No
  
  5 - Which parish did your child receive the sacrament of First Holy Communion/ Eucharist? Please enter valid data.
  
  City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
  
  5 - Has your child received the sacrament of Confirmation? Yes No
  
  5 - Which parish did your child receive the sacrament of Confirmation? Please enter valid data.
  
  City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
- 5 - Special Medical/ Educational Needs
  
  Check all boxes that apply: ADD/ADHD Austism Spectrum Behavioral/ Emotional Disorder Hearing Impairment (including deafness) Visual Impairment (including blindness) Orthopedic Impairment Speech or Langauge Impairment Child needs an individual aid in class Child unable to use stairs Developmental Disabilities Reading Difficulties (including dyslexia and dysgraphia) Special Diets
  
  5 - Other health concerns: (e.g. chronic or acute diabetes, epilepsy, hemophilia, asthma etc.) Please enter valid data.
  
  5 - Does you child have any severe allergies? (i.e. peanuts, bees, latex?) Yes No
  
  5 - Please list any allergies we should know about: Please enter valid data.
  
  5- Please list any other comments or concerns regarding your child that will help him/her to be successful in Faith Formation: Please enter valid data.
Submit

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