Faith Formation Registration

Date REQUIRED Please fill out this field. Please enter a date.

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

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

Gender

Birthdate Please enter valid data.

PLEASE MARK THE GRADE YOUR STUDENT WILL ATTEND NEXT YEAR NOT THE GRADE THEY ARE IN NOW.

Grade Level REQUIRED Please fill out this field.

Registration New Returning

Are You Registered with St. Teresa of Avila? REQUIRED Yes No Please fill out this field.

If NO, please click on the following link to register with the Parish.
www.st-teresa.com/parish-registration

Registration Year REQUIRED 2019 - 2020 Please fill out this field.

Session REQUIRED Summer (limited space) Fall Please fill out this field.

Sacraments Your Child Has Already Received Baptism First Reconciliation First Communion None

PHOTO RELEASE: Faith Formation is allowed to take photos of my child(ren) to be used in the Parish Bulletin and the Parish Website. REQUIRED Yes No Please fill out this field.

Family Last Name REQUIRED Please fill out this field. Please enter valid data.

Father's Name Please enter valid data.

Father's Email Please enter valid data.

Mother's Name Please enter valid data.

Mother's Email Please enter valid data.

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.

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

AUTHORIZED CHILD PICK UP
PLEASE NAME TWO PEOPLE (OTHER THAN YOU AND YOUR SPOUSE)

(Name and phone #) Has permission to pick up my child. REQUIRED Please fill out this field. Please enter valid data.

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

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

Primary Language Spoken at Home REQUIRED Please fill out this field.

Special Needs (Medical, Learning Disabilities, Physical Disabilities, Allergies, etc.)

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

SUMMER REGISTRANTS
PLEASE CONTINUE
(Please see attached
Documents list to the left)

Summer Commitment Form:
This form is due to Faith Formation before the Summer program begins.

Summer Family Commitment Log:
This form is due to Faith Formation by April 30, 2019.

Failure to submit or comply to the Summer Commitment Forms will result in your child repeating his/her assigned grade in the Fall.