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Form registration
[ REGISTRATION FORM ]
Dixie Catholic Faith Formation registration form
1 per family
Father's Full Name:
Religion:
Mother's Full & Maiden Name:
Religion:
Child(ren) live with
Select an option
Both Parents
Father
Mother
Other
Address:
Home Phone:
Cell or Alternate phone:
Altermate Address:
Home phone:
Cell or Alternate phone:
Father's email: / Or other
Mother's email:
Parish you are currently registerd:
I am interested in being a:
Select an option
Catechist
Assistant
Substitute
Office Assistant
None
Child 1
If this is the first time participating with our Religous Education Program please provide a copy of baptism Certification
Child's Full Name:
Grade:
Birth date:
Sex:
Select an option
Male
Female
School Attending:
Indicate date and parish each child received
Date And Parish Baptism received:
Date And Parish Eucharist received:
Date And Parish Confirmation received:
Date And Parish Reconciliation received:
Please list any learning disabilities, physical, handicaps, allergies, or other information that will help us to assist your child.:
Child 2
If this is the first time participating with our Religous Education Program please provide a copy of baptism Certification
Child's Full Name:
Grade:
Birth date:
Sex:
Select an option
Male
Female
School Attending:
Indicate date and parish each child received
Date And Parish Baptism received:
Date And Parish Eucharist received:
Date And Parish Confirmation received:
Date And Parish Reconciliation received:
Please list any learning disabilities, physical, handicaps, allergies, or other information that will help us to assist your child.:
Child 3
If this is the first time participating with our Religous Education Program please provide a copy of baptism Certification
Child's Full Name:
Grade:
Birth date:
Sex:
Select an option
Male
Female
School Attending:
Indicate date and parish each child received
Date And Parish Baptism received:
Date And Parish Eucharist received:
Date And Parish Confirmation received:
Date And Parish Reconciliation received:
Please list any learning disabilities, physical, handicaps, allergies, or other information that will help us to assist your child.:
Child 4
If this is the first time participating with our Religous Education Program please provide a copy of baptism Certification
Child's Full Name:
Grade:
Birth date:
Sex:
Select an option
Male
Female
School Attending:
Indicate date and parish each child received
Date And Parish Baptism received:
Date And Parish Eucharist received:
Date And Parish Confirmation received:
Date And Parish Reconciliation received:
Please list any learning disabilities, physical, handicaps, allergies, or other information that will help us to assist your child.:
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