Religious Education & Youth Ministry Registration for 2020-2021

Family Information

Registered Parishioner*

Family Last Name*

Address*

City*

State*

Zip Code*

Family Email Address*

Primary Phone Number*

000-000-0000

Parent Information

Father First Name*

if not applicable type NA

Father Middle Name

Father Last Name

If different than family

Is Father Catholic?*

Yes No

Religion-Dad

Father Phone*

000-000-0000

Phone Type*

Father Secondary Phone

000-000-0000

Phone Type

Father Email Address

If different than Family Email

Mother First Name*

if not applicable type NA

Mother Middle Name

Mother Last Name

if different than family

Is Mother Catholic?*

Yes No

Religion-Mom

Mother Phone*

000-000-0000

Phone Type*

Mother Secondary Phone

000-000-0000

Phone Type

Mother Email Address

If different than Family Email

Student Registration

Do you wish to register a child or youth for REYM and/or volunteer to serve in REYM during the 2020-2021 year?*

Please read the choices carefully

Student(s) Information

Student (1) Information

Student (1) First Name*

Student (1) Middle Name

Student (1) Last Name*

Student (1) Preferred Name:

Student (1) Gender*

Male Female

Student (1) Birth Date* (mm/dd/yyyy)

Student (1) Grade for 2020-2021*

Student (1)Name of School attending in 2020-2021*

Student (1) Graduation Year*

Did your Child (1) receive religious instruction last year*

Where did child (1) receive religious instruction

Student (1) Sacraments this year *

Check all that apply

Sacramental Certificates

Please attach a photo or copy of Baptismal and/or Communion Certificate if sacraments were received somewhere other than Saints Francis and Clare.

Max file size: 10 MB

Student (1) Allergies/Special Needs*

if not applicable type NA

Student(1) Lives With*

Enter who child lives with...

Please list name and relationship

Permission to print pictures and/or name*

As the parent/guardian, I hereby authorize SSFC Religious Education and Youth Ministry to publish and/or print my child's name and/or photo

I Agree I Do Not Agree

Would you like to enroll another student (2)?*

Yes No

Student 2 Information

Student (2) First Name*

Student (2) Middle Name

Student (2) Last Name*

Student (2) Preferred Name:

Student (2) Gender*

Male Female

Student (2) Birth Date* (mm/dd/yyyy)

Student (2) Grade for 2020-2021*

Student (2)Name of School attending in 2020-2021*

Student (2) Graduation Year*

Did your Child (2) receive religious instruction last year*

Where did child (2) receive religious instruction

Student (2) Sacraments this year *

Check all that apply

Sacramental Certificates(2)

Please attach a photo or copy of Baptismal and/or Communion Certificate if sacraments were received somewhere other than Saints Francis and Clare.

Max file size: 10 MB

Student (2) Allergies/Special Needs*

If not applicable type NA

Student(2) Lives With*

Enter who child lives with...

Please list name and relationship

Permission to print pictures and/or name*

As the parent/guardian, I hereby authorize SSFC Religious Education and Youth Ministry to publish and/or print my child's name and/or photo

I Agree I Do Not Agree

Would you like to enroll another student (3)?*

Yes No

Student 3 Information

Student (3) First Name*

Student (3) Middle Name

Student (3) Last Name*

Student (3) Preferred Name:

Student (3) Gender*

Male Female

Student (3) Birth Date* (mm/dd/yyyy)

Student (3) Grade for 2020-2021*

Student (3) Name of School attending in 2020-2021*

Student (3) Graduation Year*

Did your Child (3) receive religious instruction last year*

Where did child receive religious instruction

Student (3) Sacraments this year *

Check all that apply

Sacramental Certificates(3)

Please attach a photo or copy of Baptismal and/or Communion Certificate if sacraments were received somewhere other than Saints Francis and Clare.

Max file size: 10 MB

Student (3) Allergies/Special Needs*

If not applicable type NA

Student(3) Lives With*

Enter who child lives with...

Please list name and relationship

Permission to print pictures and/or name*

As the parent/guardian, I hereby authorize SSFC Religious Education and Youth Ministry to publish and/or print my child's name and/or photo

I Agree I Do Not Agree

Would you like to enroll another student (4)?*

Yes No

Student 4 Information

Student (4) First Name*

Student (4) Middle Name

Student (4) Last Name*

Student (4) Preferred Name:

Student (4) Gender*

Male Female

Student (4) Birth Date* (mm/dd/yyyy)

Student (4) Grade for 2020-2021*

Student (4) Name of School attending in 2020-2021*

Student (4) Graduation Year*

Did your Child (4) receive religious instruction last year*

Where did child receive religious instruction

Student (4) Sacraments this year *

Check all that apply

Sacramental Certificates(4)

Please attach a photo or copy of Baptismal and/or Communion Certificate if sacraments were received somewhere other than Saints Francis and Clare.

Max file size: 10 MB

Student (4) Allergies/Special Needs*

If not applicable type NA

Student(4) Lives With*

Enter who child lives with...

Please list name and relationship

Permission to print pictures and/or name*

As the parent/guardian, I hereby authorize SSFC Religious Education and Youth Ministry to publish and/or print my child's name and/or photo

I Agree I Do Not Agree

Would you like to enroll another student (5)?*

Yes No

Student 5 Information

Student (5) First Name*

Student (5) Middle Name

Student (5) Last Name*

Student (5) Preferred Name:

Student (5) Gender*

Male Female

Student (5) Birth Date* (mm/dd/yyyy)

Student (5) Grade for 2020-2021*

Student (5)Name of School attending in 2020-2021*

Student (5) Graduation Year*

Did your Child (5) receive religious instruction last year*

Where did child receive religious instruction

Student (5) Sacraments this year *

Check all that apply

Sacramental Certificates(5)

Please attach a photo or copy of Baptismal and/or Communion Certificate if sacraments were received somewhere other than Saints Francis and Clare.

Max file size: 10 MB

Student (5) Allergies/Special Needs*

If not applicable type NA

Student(5) Lives With*

Enter who child lives with...

Please list name and relationship

Permission to print pictures and/or name*

As the parent/guardian, I hereby authorize SSFC Religious Education and Youth Ministry to publish and/or print my child's name and/or photo

I Agree I Do Not Agree

Emergency/Secondary Contacts-other than parents please (in event parents can't be reached)

Emergency Contact Name *

Emergency Contact Phone *

Relationship*

Adult Volunteer for REYM 2020-2021

I want to volunteer my services to REYM*

18 years of age or older

Adult Volunteer (1) Name

Volunteer Options-Adult (18 or older)

Check all that apply

Adult-RE Catechist (Grades PreK-5) Adult-RE Catechist Assistant (Grades PreK-5) Middle School Small Group Leader High School Small Group Leader Sunday Morning RE/YM Volunteer Corps (non-teaching) RE/YM Special Events Volunteer (one-time events)

I have completed Safe and Sacred Training

Click here to complete Safe and Sacred Training

Would you like to register another volunteer

Adult Volunteer (2) Name

Volunteer (2) Options-Adult (18 or older)

Check all that apply

Adult-RE Catechist (Grades PreK-5) Adult-RE Catechist Assistant (Grades PreK-5) Middle School Small Group Leader High School Small Group Leader Sunday Morning RE/YM Volunteer Corps (non-teaching) RE/YM Special Events Volunteer (one-time events)

Volunteer (2) has completed Safe and Sacred Training

Click here to complete Safe and Sacred Training

Youth Volunteer for REYM 2020-2021

I want to volunteer a youth for REYM 2020-2021*

Any youth of high school age that has completed the Student Leadership Formation Program.

Youth Volunteer (1) Full Name

Youth Volunteer (1) Options

Would you like to register another youth volunteer (2)

Youth Volunteer (2) Full Name

Youth Volunteer (2) Options

Enrollment Fee - $25 per child,max of $60 for family of 3 children or more. If your child attends SSFC School Ministry or ECM you pay no fees due to your tuition expense. Additionally, fees are not charged for High School Students with the exception of those who are preparing for Confirmation.

Enrollment Fee*

These fees are not intended to be a financial hardship or keep your family from enjoying our programming. Please contact us if we can assist you.

Health and Safety Acknowledgment

Health Agreement*

Each week when you drop off your child/children for RE/YM you acknowledge that they are not exhibiting symptoms of Covid-19 such as cough, shortness of breath or flu-like symptoms. They must also been fever free for 72 hours without any fever reducing medication.

Yes, I have read and understand No, I do not agree

Once you have completed the entire form you will click the SUBMIT button at the bottom of the page. It will take you a page where you may pay the registration fees. YOU WILL NEED TO COMPLETE THIS PAGE TO SUBMIT THE FORM. Once done you will click the submit button again. You will then receive an email stating you have completed the process, until you see this your registration is not complete. Please contact Nikki Moore at nmoore@ss-fc.org with any questions.