Summer Faith Formation Registration

Sessions

Preschool - Ages 4 - Entering Kindergarten

Wednesday, July 18th - 2:30pm - 5:30pm

Grades 1-6

Monday, July 16th - Friday July 20th - 9:00am - 2:30pm

Grades 7-12

Sunday, July 15th - Thursday, July 19th - 7:30pm - 9:40pm

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Contact Information

Parent's Name

Required*

Address

Street 1*

Street 2

City*

State*

Zip*

Primary Phone

Required* --

Secondary Phone

Required*

Emergency Contact Name

First Name*

Last Name*

Emergency Contact Relationship

Required*

Emergency Phone Number

Required* --

Preschool Child

Only use this section if you are registering a child for the Pre-School session on Wednesday, July 18th from 2:30 - 5:30.

Preschoolers Name

First Name

Last Name

Child 1

Child's Name

First Name

Last Name

Grade in fall of 2018

Child 2

Child's Name

First Name

Last Name

List (Dropdown)

Child 3

Child's Name

First Name

Last Name

List (Dropdown)

Additional Details

Photo Permission
Required*

I give permission for St. Rose to use photos of my child on the website and/or in the bulletin.*

	Yes
	No

Special Needs/Medication

Please list child's name & needs. Send procedure plan to parish office if needed.

Parent Signature
Required*

I acknowledge that as the parent/guardian, this information will be submitted to the parish for use in registration.*

Yes