Faith Formation Returning Student Form (Multi Student) Faith Formation Returning Student Registration (Multi Students) How many children are you registering for Faith Formation Classes?* 1 2 3 4 5 First Child's InformationChild's Name* First Last Nickname Date of Birth* Month Day Year School Attending in September* Grade Entering in September*1st2nd3rd4th5th6th7th8thFaith Formation Class Requested* Weekday Sunday Second Child's InformationChild's Name First Last Nickname Date of Birth Month Day Year School Attending in September Grade Entering in September1st2nd3rd4th5th6th7th8thFaith Formation Class Requested Weekday Sunday Third Child's InformationChild's Name First Last Nickname Date of Birth Month Day Year School Attending in September Grade Entering in September1st2nd3rd4th5th6th7th8thFaith Formation Class Requested Weekday Sunday Fourth Child's InformationChild's Name First Last Nickname Date of Birth Month Day Year School Attending in September Grade Entering in September1st2nd3rd4th5th6th7th8thFaith Formation Class Requested Weekday Sunday Fifth Child's InformationChild's Name First Last Nickname Date of Birth Month Day Year School Attending in September Grade Entering in September1st2nd3rd4th5th6th7th8thFaith Formation Class Requested Weekday Sunday FAMILY INFORMATION (Please fill out only if information has changed.)Father's Name First Last Father's Religion Father's Cell PhoneFather's Email Mother's Name First Last Mother's Religion Mother's Cell PhoneMother's Email Primary Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Home PhoneHealth/Education InformationDoes your child/children have allergies, medical conditions or educational needs of which we need to be aware?* Yes No If you answered YES to the above question, can you please describe the need or condition. If multiple children please identify by child.Emergency ContactEmergency Contact Name* First Last Emergency Contact Phone*Media ReleasePhotographs and/or videos of minors are taken periodically for use in parish publications. In checking "I agree" you are acknowledging this and granting permission to Immaculate Conception Faith Formation to use photos and videos of your child/children and their names in print/electronic publications and displays.* I agree. I do NOT agree. Parent Name* Virtual Online Learning ReleaseVirtual Online Learning Permission: If necessary, my child/children has/have my permission to participate with on-line Catechesis with Immaculate Conception. I understand that a subsequent email will be forwarded providing the dates and times of the sessions.* I give permission. I DO NOT give permission. Parent Name* Volunteer InformationWe are always in need of additional teachers, substitutes and adult helpers. Please prayerfully consider helping out. Please select one of the ways listed below if you can assist us. Teacher Aide or Assistant Substitute Teacher Payment MethodPlease indicate your payment method.* Cash/Check (Please mail or drop in the rectory door mail slot at Parish Office.) Online payment (Once you submit this form you will receive a pop up that will provide a link to pay online.) Fee is $30.00 per child for IC Parishioners, maximum of $90.00 per family (3 or more) $40.00 per child for non-parishioners, $120.00 per family (3 or more) Registration is due by August 1st. Any received after this date must include a $10 late fee.