Register for Faith Formation

Primary Contact *

First Name

Last Name

Phone *

(###)

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Secondary Contact

First Name

Last Name

Secondary Phone

(###)

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Emergency Contact *

First Name

Last Name

Emergency Contact Phone *

(###)

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Primary Address *

Please enter the child(ren)'s primary address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Child(ren) live with: *

Both Parents

Father

Mother

Other (Please specify below)

Child 1 *

First Name

Last Name

Date of Birth (1) *

MM

DD

YYYY

Sacramental Prep (1) *

Please indicate if your child is attending Sacramental Prep.

2nd grade first Reconciliation/First Eucharist

My child has not been Baptized

N/A

Child 2

First Name

Last Name

Date of Birth (2)

MM

DD

YYYY

Sacramental Prep (2)

Please indicate if your child is attending Sacramental Prep.

2nd grade first Reconciliation/First Eucharist

My child has not been Baptized

N/A

Child 3

First Name

Last Name

Date of Birth 3

MM

DD

YYYY

Sacramental Prep 3

Please indicate if your child is attending Sacramental Prep.

2nd grade first Reconciliation/First Eucharist

My child has not been Baptized

N/A

Child 4

First Name

Last Name

Date of Birth 4

MM

DD

YYYY

Sacramental Prep 4

Please indicate if your child is attending Sacramental Prep.

2nd grade first Reconciliation/First Eucharist

My child has not been Baptized

N/A

If you or any other family members haven't received one of the Sacraments of Initiation (Baptism, Eucharist, or Confirmation) do you seek to receive any of them? *

In the Diocese of Winona-Rochester, First Eucharist is celebrated in 2nd grade and Confirmation in 10th grade.

Yes, I need to receive a Sacrament

Yes, one of my family members needs to receive a Sacrament

No, I do not need to receive a Sacrament

Media Release *

I hereby authorize and give full consent, without limitation or reservation, to the Co-Cathedral of St. John the Evangelist, to publish any photograph or video in which my child(ren), named above, appear(s) while participating in any program associated with St. John's. There will be no compensation for use of any photograph or video at the time of publication or in the future. Publication is defined as any print or digital media, including posts to social media, parish email updates, and bulletin articles

I agree

I decline (please submit a photo of the child/ren for office use only)

Electronic Signature *

Signing here signifies that you have read the previous statement regarding use of photos and other media.

I have read the above statement regarding media

Today's Date *

MM

DD

YYYY