2022-2023 Registration

Family Last Name REQUIRED Please fill out this field. Please enter valid data.

Father/Guardian Name Please enter valid data.

Mother/Guardian Name Please enter valid data.

Child Lives With REQUIRED Please fill out this field.

Preferred Mailing Address REQUIRED Please fill out this field. Please enter valid data.

Secondary Mailing Address Please enter valid data.

Email Address REQUIRED Please fill out this field. Please enter valid data.

Father's Cell Phone Please enter valid data.

Mother's Cell Phone Please enter valid data.

Other Phone Numbers Please enter valid data.

Father's Religion

Mother's Religion

Our family is REQUIRED Please fill out this field.

Name of Emergency Contact Person (if parents cannot be reached): REQUIRED Please fill out this field. Please enter valid data.

Phone number for emergency contact person REQUIRED Please fill out this field. Please enter valid data.

Child's Name REQUIRED Please fill out this field. Please enter valid data.

Gender REQUIRED Please fill out this field.

Child's Date of Birth REQUIRED Please fill out this field. Please enter valid data.

Grade for 2022-2023 REQUIRED Please fill out this field.

School Attending Please enter valid data.

I would like to register this child for: REQUIRED Ages 3-6 (Level 1) Catechesis of the Good Shepherd; Tuesdays 10-11:30am Ages 3-6 (Level 1) Catechesis of the Good Shepherd; Wednesdays 4-5:30pm Ages 3-6 (Level 1) Catechesis of the Good Shepherd; Wednesdays 6-7:30pm Grades 1-5 (Level 2) Catechesis of the Good Shepherd; Tuesdays 10-11:30am Grades 1-5 (Level 2) Catechesis of the Good Shepherd; Wednesdays 4-5:30pm Grades 1-5 (Level 2) Catechesis of the Good Shepherd; Wednesdays 6-7:30pm Please fill out this field.

Please list any allergies or health concerns we should be aware of: REQUIRED Please fill out this field.

Please tell us about your child’s educational needs so we can provide the best experience for them (check any that apply): My child is not yet potty-trained My child needs help in the bathroom (please note that you or a designated trusted adult must be present to help with this) My child is shy about asking for help My child has a hard time expressing their needs in words My child can’t read yet My child reads at/above grade level My child doesn’t like to read in front of others My child has extra energy that they may need help focusing My child has ADD/ADHD or another diagnosed educational need

Other helpful notes for us (child’s needs, custody arrangements, etc): Please enter valid data.

2nd Child's Name Please enter valid data.

Gender

Child's Date of Birth Please enter valid data.

Grade for 2022-2023 REQUIRED Please fill out this field.

School Attending Please enter valid data.

I would like to register this child for: REQUIRED Ages 3-6 (Level 1) Catechesis of the Good Shepherd; Tuesdays 10-11:30am Ages 3-6 (Level 1) Catechesis of the Good Shepherd; Wednesdays 4-5:30pm Ages 3-6 (Level 1) Catechesis of the Good Shepherd; Wednesdays 6-7:30pm Grades 1-5 (Level 2) Catechesis of the Good Shepherd; Tuesdays 10-11:30am Grades 1-5 (Level 2) Catechesis of the Good Shepherd; Wednesdays 4-5:30pm Grades 1-5 (Level 2) Catechesis of the Good Shepherd; Wednesdays 6-7:30pm Please fill out this field.

Please list any allergies or health concerns we should be aware of: REQUIRED Please fill out this field.

Please tell us about your child’s educational needs so we can provide the best experience for them (check any that apply): My child is not yet potty-trained My child needs help in the bathroom (please note that you or a designated trusted adult must be present to help with this) My child is shy about asking for help My child has a hard time expressing their needs in words My child can’t read yet My child reads at/above grade level My child doesn’t like to read in front of others My child has extra energy that they may need help focusing My child has ADD/ADHD or another diagnosed educational need

Other helpful notes for us (child’s needs, custody arrangements, etc): Please enter valid data.

3rd Child's Name Please enter valid data.

Gender

Child's Date of Birth Please enter valid data.

Grade for 2022-2023 REQUIRED Please fill out this field.

School Attending Please enter valid data.

I would like to register this child for: REQUIRED Ages 3-6 (Level 1) Catechesis of the Good Shepherd; Tuesdays 10-11:30am Ages 3-6 (Level 1) Catechesis of the Good Shepherd; Wednesdays 4-5:30pm Ages 3-6 (Level 1) Catechesis of the Good Shepherd; Wednesdays 6-7:30pm Grades 1-5 (Level 2) Catechesis of the Good Shepherd; Tuesdays 10-11:30am Grades 1-5 (Level 2) Catechesis of the Good Shepherd; Wednesdays 4-5:30pm Grades 1-5 (Level 2) Catechesis of the Good Shepherd; Wednesdays 6-7:30pm High School Aftershock Program; Sundays 6-8pm Confirmation Preparation; Wednesdays 6-8pm Please fill out this field.

Please list any allergies or health concerns we should be aware of: REQUIRED Please fill out this field.

Please tell us about your child’s educational needs so we can provide the best experience for them (check any that apply): My child is not yet potty-trained My child needs help in the bathroom (please note that you or a designated trusted adult must be present to help with this) My child is shy about asking for help My child has a hard time expressing their needs in words My child can’t read yet My child reads at/above grade level My child doesn’t like to read in front of others My child has extra energy that they may need help focusing My child has ADD/ADHD or another diagnosed educational need

Other helpful notes for us (child’s needs, custody arrangements, etc): Please enter valid data.

Media Release: I give my permission for my child(ren) to be photographed or videotaped during Faith Formation events for use on the parish website or other parish promotional materials. REQUIRED Yes, I agree. No, please opt our family out. Please fill out this field.

EMERGENCY MEDICAL TREATMENT: In the event of an emergency, I hereby give permission to transport my child to a hospital for emergency medical or surgical treatment. I wish to be advised prior to any further treatment by the hospital or doctor. REQUIRED Yes, I agree. Please fill out this field.

Medical Release: Please check one of the following: No medication of any type, whether prescription or non-prescription, may be administered to my child unless the situation is life threatening and emergency treatment is required.  I hereby grant permission for non-prescription medication (i.e. non-aspirin products such as acetaminophen or ibuprofen, throat lozenges,) to be given to my child, if deemed appropriate.

To support the children I would like to:

2022-2023 Registration

To Register...

2022-2023 Child Faith Formation Registration