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					FAMILY NAME: ___________________________________

                          St. Bernadette Parish Faith Formation Program Registration for 2012 - 2013
                                PLEASE BE SURE YOU COMPLETE ALL INFORMATION REQUESTED ON BOTH SIDES OF THE FORM.
                                            PLEASE SIGN AND DATE ON SIDE -2- BEFORE RETURNING THIS FORM!
                                  NOTE: COMPLETION OF THIS FORM DOES NOT REGISTER YOUR CHILD FOR SACRAMENTAL PREPARATION!

Please print or type all information.
Parent’s Last Name           Parent’s First Name       Parent’s Cell Number        Parent’s Work Number         Parent’s Email

Street Address                                         City, State                 Zip                          Home Phone Number

Parent’s Last Name            Parent’s First Name      Parent’s Cell Number        Parent’s Work Number         Parent’s Email

Street Address                                         City, State                 Zip                          Home Phone Number


Child(ren) reside with:   □ Both Parents   □ One Parent ______________________      □ Guardian

Student Information
Child(ren)’s First Name(s)      Gender          Birthdate     Grade in        Special Needs/Health Concerns                            Check Sacraments
                                                              School                                                                   Already Received
(Use Last only if different     M/F             M/DD/YYYY     2012-13         (Food Allergies, IEP, Reading Difficulties, etc.)   Baptism   Reconcil- Eucharist
from Family Name)                                                                                                                           iation




• My child(ren) have been previously enrolled in a Catholic Religious Education Program: □ NO        □ YES
       If YES, please indicate program information:
                Catholic School during the years _________________
                Catholic Religious Education Program during the years __________________ at (Parish/School) ______________________________

                                                                                           in (City/State)__________________________________________
       Fees: Make checks payable to St. Bernadette                              No child is ever denied religious education because of an
        # of Children                                                           inability pay. If you need a waiver or discount of your tuition,
        Single Child                 $ 85                                       please contact Pat Radford, Coordinator of Religious
        Two Children                 $ 160                                      Education, or Marge Sholl, Coordinator of Youth Ministry, as
        Three or more Children       $ 200                                      soon as your need is known.

By registering my child(ren) in the Faith Formation Program, I understand that:

      My family must be registered at St. Bernadette parish.

      I agree to pay tuition in the amount indicated on the tuition scale (above). I understand that in order for my child(ren)’s registration to
       be processed, I must pay at least a $35 deposit which will be applied to my total tuition or contact the parish office for a waiver of the
       tuition.

      Completion of this form does not register my child for Sacramental Preparation. For Sacramental Preparation information, please
       contact Pat Radford, Coordinator of Religious Education (1 st Communion, Reconciliation) or Marge Sholl, Coordinator of Youth Ministry
       (Confirmation).

      As an integral part of our faith formation curriculum, we will be teaching Catechesis for Family Life. This age-appropriate program about
       Christian living, chastity, character formation, and safe environment training promotes communication between you and your child. You
       are encouraged to review the program materials that the teacher/catechist will be using in the classroom, as well as the materials you
       will receive for home discussion. After examining the program, if you have any questions or concerns about your child participating in
       this program, please contact Pat Radford (Early Childhood and Elementary programs) or Marge Sholl (Middle School and High School
       programs).

      Staff and volunteers may take photos during religious education classes, sacramental preparation activities, youth events and
       parish/community events at St. Bernadette. These photos may be used in parish-wide displays and publications, including the annual
       religion fair poster displays, the Annual report and the parish website. No identifying information, including names, will be posted with
       the photos in the event of their use. If you do not want your child’s photograph to be taken and/or used, please inform the parish staff
       in writing.

      Children in the Early Childhood and Elementary programs must be walked in and picked up inside Archbishop Spalding High School at
       dismissal time. Children will not be allowed to leave Archbishop Spalding without an adult.


Date___________________ Parent Signature_______________________________________________________________________

				
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posted:9/29/2012
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