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Download 20____-20____ Faith Formation Registration Form
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HOLYCROSSCATHOLICCHURCH Office of Faith Formation 7851 54th Avenue North St. Petersburg, FL 33709 Ph. (727) 546-9654| Fax (727) 547-2005 20____‐20____FaithFormationRegistrationForm Complete one form per child. Registration form must be accompanied with payment. The Registration Fee is $25.00 per child (NonSacramental Fee) and $50.00 per child (Sacramental Fee). If full payment can not be made, a payment plan must be made. Student Information Envelope #: _____________ First Name :_____________________________________ Last Name :_____________________________________ Gender: (Circle) Male Female Date of Birth: _____/_____/______Grade (20____-20___): ____________ Sacramental Information: Date Parish Location Baptism: _________________________________________________________________________________ Communion: _________________________________________________________________________________ Confirmation: _________________________________________________________________________________ Family Background Family Name: _____________________________________ Mother’s Name :___________________________________ Father’s Name :___________________________________ Address: _________________________________________________________________________________________ City: ____________________________________ State: FL Zip:_____________ Phones: Home Cell Work Emergency ________________ ________________ ________________ ________________ Email Address: ______________________________________ Additional Information Please list any additional information such as allergies, designated people who may pick up your child or custody agreements: __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ Media Release Statement I hereby GRANT / DECLINE (circle one) permission for my child/children named on this form to be photographed and/or videotaped during Faith Formation activities and events; and for the resulting photographs and/or videotaped footage to be edited, if necessary, and then published and/or broadcast (newspaper, church bulletin, church website etc.) for the purpose of promoting the activities of Holy Cross Catholic Church. ______________________________________________________ ___________________ Parent/Guardian Signature Date HOLYCROSSCATHOLICCHURCH Office of Faith Formation 7851 54th Avenue North St. Petersburg, FL 33709 Ph. (727) 546-9654| Fax (727) 547-2005 20___‐20___RegistracióndelaFormacióndeFe Completa un formulario para cada niño. Formulario de inscripción debe ir acompañado con el pago. La cuota de inscripción es de $ 25.00 por niño (no sacramental de tasas) y $ 50.00 por niño (Cuota sacramental). Si el pago completo no se puede hacer, un plan de pago debe ser hecho. Información del Estudiante Numero de Sobre#: _____________ Nombre:_____________________________________ Apellidos :_____________________________________ Sexo: (Circule) Masculino o Feminino Fecha de Nacimiento: _____/_____/______Grado (20__ - 20__): ___________ Informatión de los Sacramentos: Fecha Parroquia Dirrección Bautismo: _________________________________________________________________________________ Comunión: _________________________________________________________________________________ Confirmación: _________________________________________________________________________________ Antecededentes Familiares Apellidos: _____________________________________ Madre :___________________________________ Padre :___________________________________ Dirrección: ________________________________________________________________________________________ Cuidad: ____________________________________ Estado: FL Zona Postal:_____________ Teléphono: Hogar ________________ Celular Trabajo Emergencia ________________ ________________ ________________ Correo Electrónico: ______________________________________ Información Adicional Por favor escriba cualquier información adicional, como las alergias, las personas designadas que puedan recoger a su hijo o de acuerdos de custodia: __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ Declaración de Medios de Publicación Por la presente OTORGO / DESCENSO (circule uno) permiso para que mi niño / niños nombrados en este formulario para ser fotografiado y / o grabado en video durante las actividades de Formación en la Fe y eventos, y para las fotografías resultantes y / o imágenes grabadas en vídeo para ser editado, si es necesario, y luego publicado y / o difusión (prensa, boletín de la iglesia, el sitio web la iglesia, etc) con el propósito de promover las actividades de la Santa Cruz Iglesia Católica. ______________________________________________________ Firma del Padres ___________________ Fecha HOLYCROSSCATHOLICCHURCH Office of Faith Formation 7851 54th Avenue North St. Petersburg, FL 33709 Ph. (727) 546-9654| Fax (727) 547-2005 RegistrationCheckList Student Information Last Name :_________________________ First Name :_______________________ Grade (20____-20____): ________ Records & Forms 20___-20___ Faith Formation Registration Form Baptismal Certificate Sacrament Registration Form Confirmation Sponsor Form Payment Information Total Assessed: ____________________________ Paid in Full: ____________________________________________________________________________________ Payment Info: __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________
