2020-21 Religious Formation Registration Form :: Our Lady of the Lakes Catholic Church

Family Name*
Home Phone
Cell Phone
Parent's Name: (Father)*
Parent's Name: (Mother)*
Work Phone: (Father)
Work Phone: (Mother)
Email Address
Address
Emergency Contact
Parent's Religion (If Not Catholic): (Father)
Parent's Religion (If Not Catholic): (Mother)
Name & Relationship
Phone # Of Emergency Contact
We are Registered Members Of Our Lady Of the Lakes Parish
- Yes
- No
If not, What Parish?
Check Sacraments Received For Each Child
1. Youth Name
Birthdate
Date Format: MM slash DD slash YYYY
Grade
School
Baptism
Ist Eucharist
Ist Reconcilation
Confirmation
Medical Notes (Allergies, Medications etc)
2. Youth Name
Birthdate
Date Format: MM slash DD slash YYYY
Grade
School
Baptism
Ist Eucharist
Ist Reconcilation
Confirmation
Medical Notes (Allergies, Medications etc)
3. Youth Name
Birthdate
Date Format: MM slash DD slash YYYY
Grade
School
Baptism
Ist Eucharist
Ist Reconcilation
Confirmation
Medical Notes (Allergies, Medications etc)
4. Youth Name
Birthdate
Date Format: MM slash DD slash YYYY
Grade
School
Baptism
Ist Eucharist
Ist Reconcilation
Confirmation
Medical Notes (Allergies, Medications etc)
WE ARE HERE TO ACCOMMODATE THE NEED OF EVERY CHILD. PLEASE NOTE ANY PHYSICAL OR LEARNING PROBLEMS (I.E. LEARNING DISABILITIES, BEHAVIORAL CONCERNS, ETC.) SO THE CATECHIST MAY BE BETTER PREPARED TO INSTRUCT YOUR CHILD. (THIS INFORMATION WILL BE KEPT STRICTLY CONFIDENTIAL.)
ARE THERE ANY OTHER SITUATIONS THAT WE SHOULD BE AWARE OF?
PLEASE LIST ANY SPECIAL WAYS THAT WE COULD HELP YOUR YOUTH IN THEIR EDUCATIONAL/SPIRITUAL NEEDS.
Office Use Only
Date
Date Format: MM slash DD slash YYYY
Received By
OVER Sign