K-12 Faith Formation / Sacrament Registration Form

- Faith Formation
Contact Us
- Tommy Cordova
  
  Director of Faith Formation
  
  346-335-1816

Faith Formation Registration Form
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- CANDIDATE INFORMATION
- Family Last Name REQUIRED Please fill out this field. Please enter valid data.
- Family Address REQUIRED Please fill out this field. Please enter valid data.
- City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
- Family Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Text Message Accepted REQUIRED Please fill out this field.
- Main Family Email REQUIRED
  All email communications will be sent to this email.
  Please fill out this field. Please enter an email address.
- Preferred Communication Method REQUIRED Please fill out this field.
- Photo Release - Do you give St. Theresa's permission to photograph or video your child to use and publish online or in print only on official parish website or printable media. Yes No
- Parent/Guardian Information
- Number of Parents Registering REQUIRED Please fill out this field.
  
  Parent 1
  
  Parent/Guardian REQUIRED Please fill out this field.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Religion REQUIRED Please fill out this field.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Text Accepted REQUIRED Please fill out this field.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Are you able to volunteer? REQUIRED Yes No Maybe Please fill out this field.
  
  Parent 2
  
  Parent/Guardian REQUIRED Please fill out this field.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Religion REQUIRED Please fill out this field.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Text Accepted REQUIRED Please fill out this field.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Are you able to volunteer? REQUIRED Yes No Maybe Please fill out this field.
- Emergency Contact Information
- Emergency Contact First Name and Last Name REQUIRED Please fill out this field. Please enter valid data.
- Emergency Contact Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Child's/Children's Information
- Number of Children Registering REQUIRED Please fill out this field.
  
  Child 1
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Please fill out this field.
  
  Grade for 2023-24 REQUIRED Please fill out this field. Please enter valid data.
  
  Did your child attend Faith Formation last year? REQUIRED Yes No Please fill out this field.
  
  Sacraments Already Received? REQUIRED
  Check all Sacraments that your child has already received
  None Baptism Eucharist Confirmation Reconciliation Please fill out this field.
  
  If Baptized - name of parish or church
  Please list full name of church where child received Baptism
  Please enter valid data.
  
  School currently attending? Please enter valid data.
  
  Allergies, medical conditions, or special needs? REQUIRED
  Please list any allergies or medical conditions that we should be aware of in order to better serve your child's needs.
  Please fill out this field. Please enter valid data.
  
  Child 2
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Please fill out this field.
  
  Grade for 2023-24 REQUIRED Please fill out this field. Please enter valid data.
  
  Did your child attend Faith Formation last year? REQUIRED Yes No Please fill out this field.
  
  Sacraments Already Received? REQUIRED
  Check all Sacraments that your child has already received
  None Baptism Eucharist Confirmation Reconciliation Please fill out this field.
  
  If Baptized - name of parish or church
  Please list full name of church where child received Baptism
  Please enter valid data.
  
  School currently attending? Please enter valid data.
  
  Allergies, medical conditions, or special needs? REQUIRED
  Please list any allergies or medical conditions that we should be aware of in order to better serve your child's needs.
  Please fill out this field. Please enter valid data.
  
  Child 3
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Please fill out this field.
  
  Grade for 2023-24 REQUIRED Please fill out this field. Please enter valid data.
  
  Did your child attend Faith Formation last year? REQUIRED Yes No Please fill out this field.
  
  Sacraments Already Received? REQUIRED
  Check all Sacraments that your child has already received
  None Baptism Eucharist Confirmation Reconciliation Please fill out this field.
  
  If Baptized - name of parish or church
  Please list full name of church where child received Baptism
  Please enter valid data.
  
  School currently attending? Please enter valid data.
  
  Allergies, medical conditions, or special needs? REQUIRED
  Please list any allergies or medical conditions that we should be aware of in order to better serve your child's needs.
  Please fill out this field. Please enter valid data.
  
  Child 4
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Please fill out this field.
  
  Grade for 2023-24 REQUIRED Please fill out this field. Please enter valid data.
  
  Did your child attend Faith Formation last year? REQUIRED Yes No Please fill out this field.
  
  Sacraments Already Received? REQUIRED
  Check all Sacraments that your child has already received
  None Baptism Eucharist Confirmation Reconciliation Please fill out this field.
  
  If Baptized - name of parish or church
  Please list full name of church where child received Baptism
  Please enter valid data.
  
  School currently attending? Please enter valid data.
  
  Allergies, medical conditions, or special needs? REQUIRED
  Please list any allergies or medical conditions that we should be aware of in order to better serve your child's needs.
  Please fill out this field. Please enter valid data.
  
  Child 5
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Please fill out this field.
  
  Grade for 2023-24 REQUIRED Please fill out this field. Please enter valid data.
  
  Did your child attend Faith Formation last year? REQUIRED Yes No Please fill out this field.
  
  Sacraments Already Received? REQUIRED
  Check all Sacraments that your child has already received
  None Baptism Eucharist Confirmation Reconciliation Please fill out this field.
  
  If Baptized - name of parish or church
  Please list full name of church where child received Baptism
  Please enter valid data.
  
  School currently attending? Please enter valid data.
  
  Allergies, medical conditions, or special needs? REQUIRED
  Please list any allergies or medical conditions that we should be aware of in order to better serve your child's needs.
  Please fill out this field. Please enter valid data.
  
  Child 6
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Please fill out this field.
  
  Grade for 2023-24 REQUIRED Please fill out this field. Please enter valid data.
  
  Did your child attend Faith Formation last year? REQUIRED Yes No Please fill out this field.
  
  Sacraments Already Received? REQUIRED
  Check all Sacraments that your child has already received
  None Baptism Eucharist Confirmation Reconciliation Please fill out this field.
  
  If Baptized - name of parish or church
  Please list full name of church where child received Baptism
  Please enter valid data.
  
  School currently attending? Please enter valid data.
  
  Allergies, medical conditions, or special needs? REQUIRED
  Please list any allergies or medical conditions that we should be aware of in order to better serve your child's needs.
  Please fill out this field. Please enter valid data.
  
  Child 7
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Please fill out this field.
  
  Grade for 2023-24 REQUIRED Please fill out this field. Please enter valid data.
  
  Did your child attend Faith Formation last year? REQUIRED Yes No Please fill out this field.
  
  Sacraments Already Received? REQUIRED
  Check all Sacraments that your child has already received
  None Baptism Eucharist Confirmation Reconciliation Please fill out this field.
  
  If Baptized - name of parish or church
  Please list full name of church where child received Baptism
  Please enter valid data.
  
  School currently attending? Please enter valid data.
  
  Allergies, medical conditions, or special needs? REQUIRED
  Please list any allergies or medical conditions that we should be aware of in order to better serve your child's needs.
  Please fill out this field. Please enter valid data.
  
  Child 8
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Please fill out this field.
  
  Grade for 2023-24 REQUIRED Please fill out this field. Please enter valid data.
  
  Did your child attend Faith Formation last year? REQUIRED Yes No Please fill out this field.
  
  Sacraments Already Received? REQUIRED
  Check all Sacraments that your child has already received
  None Baptism Eucharist Confirmation Reconciliation Please fill out this field.
  
  If Baptized - name of parish or church
  Please list full name of church where child received Baptism
  Please enter valid data.
  
  School currently attending? Please enter valid data.
  
  Allergies, medical conditions, or special needs? REQUIRED
  Please list any allergies or medical conditions that we should be aware of in order to better serve your child's needs.
  Please fill out this field. Please enter valid data.
- Learning Option
- Which Learning Option Do You Want? REQUIRED Please fill out this field.
Submit

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Please pay after submitting this registration form (see confirmation email or click CLICK HERE TO PAY
For financial assistance please contact Tommy Cordova t.cordova@sttheresa.cc or 346-335-1816. All request for financial assistance are confidential.

K-12 Faith Formation / Sacrament Registration Form

Parent/Guardian Information

Emergency Contact Information

Child's/Children's Information

Learning Option