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1 OFFICE USE ONLY: Date: Grade in School 2018/19: FHC: 1 / 2 / Post RCIA DAY: TIME: Catechist: Paid in Full Yes No Cash Check # CC: New Student: Yes No Date on database: Staff Initials: Saturday: Sunday: Monday: RCIA: Yes No Student s Information (Información del estudiante): ST. MARY S FAITH FORMATION REGISTRATION FORM Last Name: First Name: Middle Name: Age: (Apellido del estudiante) (Nombre) (Segundo Nombre) Date of Baptism Name of Church Catholic Church? Birthdate: (Fecha de baptismo) (Nombre de Iglesia) ( Iglesia Católica?) (Fecha de nacimiento) Primary Address City State: Zip (Dirección) (Ciudad) (Estado) (Código postal) * Address (dirección de correo Updates by text list cell numbers: ( )- - 2 nd cell ( )- - (Actualizaciones por texto, enumere los números de teléfonos celulares) Primary language spoken: *Preferred language of written materials for parents: English Spanish (lenguaje primario) (Lenguaje preferido de material escrito para padres) Father s Full Name: Father s Cell # ( ) - Religion: (Nombre del Padre) (Número celular del padre) (Religión) Mother s Full Name: Mother s Maiden Name: Religion: (Nombre del Madre) (Apellido de soltera) (Religión) Father s Cell # ( ) - Occupation Mother s Cell # ( ) Occupation (Número celular del padre) (Número celular del Madre)

2 Are you married through the Catholic Church? Yes No If not, would you like to be? Yes No ( Estás casado por la Iglesia Católica?) (Si no, te gustaría ser?) Student lives with (Estudiante vive con): Both Parents Mother Only Father Only Father/Stepmother Mother/Stepfather Guardian Other (Ambos Padres) (Madre solo) (Padre solo) (Padre/madrastra) (Madre/padrastro) (Otro) Non-Custodial Parent: If a non-custodial parent needs to be communicated with please provide name, cell and address. (Padre sin custodia: si un padre sin custodia necesita ser comunicado. Proporcione el nombre, la celda y la dirección de correo electrónico). Name: Cell#: (Nombre) (Número celular) (Dirección de correo electrónico) Address: City: State: Zip code: (Dirección) (Ciudad) (Estado) (Código postal) Special Needs: Does your child have special needs, severe allergies, medical conditions or learning disabilities, etc? Please identify: (Problemas de salud, problemas de aprendizaje o comportamiento que debemos saber) Health Information/Concerns (Información de salud / preocupaciones): Important/(Importante): Incomplete forms and forms without payment WILL NOT BE PROCESSED. Minimum payment $50.00 (Los formularios incompletos y los formularios sin pago NO SERÁN PROCESADOS. Pago mínimo $50.00) Students are assigned to classes on a first-come basis, subject to teacher availability. (Los estudiantes son asignados a las clases por orden de llegada, sujeto a la disponibilidad del maestro.) Payment Options: I have included full payment with registration. (He incluido el pago completo con el registro.) I will pay in full on or before first day of class. (Pagaré en su totalidad el primer día de clase o antes.) I would like to discuss payment arrangements (Tuition may be divided into 3 payments) (Me gustaría discutir los arreglos de pago (la matrícula puede dividirse en 3 pagos) I would like to discuss partial financial assistance. (Me gustaría hablar de asistencia financiera.)

3 *PHOTO RELEASE (PUBLICACION DE FOTO): Parent Authorization, consent and release. (Autorización de los padres, consentimiento y liberación.) The undersigned parent hereby authorizes and consents that St. Mary s Faith Formation staff be permitted to use and publish for publicity purposes, the name and likeness of my child. (El padre abajo firmante autoriza y consiente que se permita al personal de la oficina de Formación de Fe de Sta. María utilizar y publicar con fines publicitarios, el nombre y la imagen de mi hijo) or for any other lawful purpose whatsoever, including electronic media. (o para cualquier otro propósito legal, incluidos los medios electrónicos.) The parent acknowledges having read this release, having the opportunity to consider and understand its terms and does hereby execute it voluntarily with knowledge and its significance. (El padre reconoce haber leído este comunicado, tener la oportunidad de considerar y comprender sus términos y por este medio ejecutarlo de manera voluntaria con conocimiento y su significado.) Parent/Guardian Signature: Date: (Firma de Padre / Guardián) (Fecha) FIRST HOLY COMMUNION MASS AGREEMENT (COMPROMISO DE MISA DE PRIMERA COMUNION): As first teachers of the faith I agree that upon the day my child/children receive the Sacrament of First Holy Communion I will be seated with my child/children and witness my child/children receive the Sacrament. I understand that Sponsors are not required for the Sacrament of First Holy Communion and that only parent(s) will be seated with their child/children at Mass. No Exceptions. Yo entiendo que, como el educador principal de fe, el día que mi hijo(a) reciba el Sacramento de la Primera Comunión, Yo(nosotros) me sentare con mi hijo(a) y seré testigo cuando reciba el Sacramento. Yo entiendo que padrinos para la Primera Comunión no son requeridos y que solamente los padres se sentaran con los niño/s en Misa. No hay excepciones. Parent/Gardian Signature/Firma de Padre/Guardián Date/Fecha

4 ST. MARY S FAITH FORMATION PARENT COVENANT At your child s Baptism, you accepted the responsibility for training your child(ren) in the practice of the Catholic Faith, which includes bringing your child up to keep God s Commandments as Christ taught by loving God and our neighbor. The covenant below outlines the responsibilities of parents in the raising of the child in our Catholic Faith. I, parent(s) of (names of children enrolled in program) Promise to faithfully raise my child(ren) in the practices of our Catholic Faith which includes: STA. MARIA FORMACION DE FE PROMESA DE COMPROMISO DE LOS PADRES En el bautismo de su hijo, usted aceptó la responsabilidad de la formación de su hijo (a) en la práctica de la fe católica, que incluye llevar a su hijo hasta los mandamientos de Dios como Cristo enseño por el amor a Dios y al prójimo. El pacto continuación se describen las responsabilidades de los padres en la crianza del niño en nuestra Fe Católica. Yo, padre (s) de (Nombres de los niños inscritos en el programa) Prometer fidelidad para elevar mi hijo (a) en la práctica de nuestra fe católica, que incluye: Attending Mass each week with my child Leading and encouraging prayer at home Participating in the family and parent activities of the program (by attending all required Family Gatherings) Ensuring that our children attend required classes and complete homework assignments Complete 4 Life of the Parish events Asistir a misa cada semana con mi hijo Dirigir y fomentar la oración en el hogar Participar en las actividades del programa de la familia y de los padres (por asistir a todas las reuniones familiares requerido) y 4 eventos de La vida Parroquial Asegurar que nuestros hijos asistan a clases requeridas y completa sus tareas escolares x Parent/Guardian Signature Date x Firma de Padre/Guardián Fecha

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