Faith Formation Registration 2021-2022

Family Information

Parish *

St. Rose of Lima, Topsfield

St. Agnes, Middleton

My family is not registered at a parish. We would like to register at St. Rose.

My family is not registered at a parish. We would like to register at St. Agnes.

My family is registered at another parish and we do not plan to change parishes. (Please list your parish.)

Parish My family is registered at another parish and we do not plan to change parishes. (Please list your parish.)

Parent 1

First Name *

Last Name *

Maiden Name (if parent 1 is mother)

Address *

Address 1

Address 2

City

State

ZIP code

Home Phone

Cell Phone *

Email *

Check here if this parent would like more information about volunteering.

Please considering sharing your time and talent!

Parent 2

First Name

Last Name

Maiden Name (if parent 2 is mother)

Address (if different from Parent 1)

Country

Address 1

Address 2

City

State

ZIP code

Home Phone (if different from Parent 1)

Cell Phone

Check here if this parent would like more information about volunteering.

Please considering sharing your time and talent!

Emergency Contact (to call after trying both parents)

Full Name *

Relation to Child(ren) *

Emergency Contact Phone *

Children

Child 1

First Name *

Middle Name

Last Name *

Sex *

Male

Female

Date of Birth *

Month

Day

Year

Grade (2021-2022) *

Has child been baptized? *

Yes

Date of Baptism

Month

Day

Year

Place of Baptism

If this child was baptized somewhere other than St. Rose or St. Agnes, please upload a copy or clear picture of their Baptismal Certificate. If you are not able to find your child's Baptismal Certificate now, please send a copy to the parish office as soon as possible.

Files must be less than 10 MB.
Allowed file types: gif jpg jpeg png bmp eps tif pict psd txt rtf html pdf doc docx odt ppt pptx odp xls xlsx ods xml.

Please list any health concerns, allergies, special needs, learning disabilities, anxieties, family circumstances, etc. that we should be aware of.

Child 2

First Name

Middle Name

Last Name

Sex

Male

Female

Date of Birth

Month

Day

Year

Grade (2021-2022)

Has child been baptized?

Yes

Date of Baptism

Month

Day

Year

Place of Baptism

Files must be less than 10 MB.
Allowed file types: gif jpg jpeg png bmp eps tif pict psd txt rtf html pdf doc docx odt ppt pptx odp xls xlsx ods xml.

Please list any health concerns, allergies, special needs, learning disabilities, anxieties, family circumstances, etc. that we should be aware of.

Child 3

First Name

Middle Name

Last Name

Sex

Male

Female

Date of Birth

Month

Day

Year

Grade (2021-2022)

Has child been baptized?

Yes

Date of Baptism

Month

Day

Year

Place of Baptism

Files must be less than 10 MB.
Allowed file types: gif jpg jpeg png bmp eps tif pict psd txt rtf html pdf doc docx odt ppt pptx odp xls xlsx ods xml.

Please list any health concerns, allergies, special needs, learning disabilities, anxieties, family circumstances, etc. that we should be aware of.

Child 4

First Name

Middle Name

Last Name

Sex

Male

Female

Date of Birth

Month

Day

Year

Grade (2021-2022)

Has child been baptized?

Yes

Date of Baptism

Month

Day

Year

Place of Baptism

Files must be less than 10 MB.
Allowed file types: gif jpg jpeg png bmp eps tif pict psd txt rtf html pdf doc docx odt ppt pptx odp xls xlsx ods xml.

Please list any health concerns, allergies, special needs, learning disabilities, anxieties, family circumstances, etc. that we should be aware of.

Child 5

First Name

Middle Name

Last Name

Sex

Male

Female

Date of Birth

Month

Day

Year

Grade (2021-2022)

Has child been baptized?

Yes

Date of Baptism

Month

Day

Year

Place of Baptism

Files must be less than 10 MB.
Allowed file types: gif jpg jpeg png bmp eps tif pict psd txt rtf html pdf doc docx odt ppt pptx odp xls xlsx ods xml.

Please list any health concerns, allergies, special needs, learning disabilities, anxieties, family circumstances, etc. that we should be aware of.

Child 6

First Name

Middle Name

Last Name

Sex

Male

Female

Date of Birth

Month

Day

Year

Grade (2021-2022)

Has child been baptized?

Yes

Date of Baptism

Month

Day

Year

Place of Baptism

Files must be less than 10 MB.
Allowed file types: gif jpg jpeg png bmp eps tif pict psd txt rtf html pdf doc docx odt ppt pptx odp xls xlsx ods xml.

Please list any health concerns, allergies, special needs, learning disabilities, anxieties, family circumstances, etc. that we should be aware of.

Comments

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