Continuing Faith Formation Registration

First name REQUIRED Please fill out this field. Please enter valid data.

Middle name REQUIRED Please fill out this field. Please enter valid data.

Last name REQUIRED Please fill out this field. Please enter valid data.

Street REQUIRED Please fill out this field. Please enter valid data.

Apartment # 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.

Date of Birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter valid data.

Place of birth (city & state) REQUIRED Please fill out this field. Please enter valid data.

Age as of September 2022 REQUIRED Please fill out this field. Please enter valid data.

School (Fall 2022) REQUIRED Please fill out this field. Please enter valid data.

City of school REQUIRED Please fill out this field. Please enter valid data.

Grade in Fall 2022 REQUIRED Please fill out this field. Please enter valid data.

Known allergies Please enter valid data.

Known special needs or assistance Please enter valid data.

Other important information

Child's Sacramental Information

Are you requesting any sacramental preparation for your child? REQUIRED Baptism First Communion My child has received Baptism & First Communion Please fill out this field.

Baptism

Full name on Baptismal certificate REQUIRED Please fill out this field. Please enter valid data.

Date of Baptism REQUIRED Please fill out this field. Please enter valid data.

Church of Baptism REQUIRED Please fill out this field. Please enter valid data.

City & state of church REQUIRED Please fill out this field. Please enter valid data.

First Communion

Date of First Communion REQUIRED Please fill out this field. Please enter valid data.

Church of First Communion REQUIRED Please fill out this field. Please enter valid data.

City & state of church REQUIRED Please fill out this field. Please enter valid data.

Parent Information

Parents' preferred language REQUIRED English Spanish (Español) Other Please fill out this field.

If other, what language? Please enter valid data.

Mother's full name REQUIRED Please fill out this field. Please enter valid data.

Mother's cell phone number REQUIRED

Use dashes, no spaces or parentheses/Usar guiones

Please fill out this field. Please enter a phone number.

Mother's Email Address REQUIRED Please fill out this field. Please enter an email address.

Father's full name REQUIRED Please fill out this field. Please enter valid data.

Father's cell phone number REQUIRED

Use dashes, no spaces or parentheses/Usar guiones

Please fill out this field. Please enter a phone number.

Father's Email Address REQUIRED Please fill out this field. Please enter an email address.

First person to contact REQUIRED Mother Father Other Please fill out this field.

If other, please indicate name, relationship and cell phone number.

Information for "other" contact

Emergency Contact OTHER than parent

Name of emergency contact REQUIRED Please fill out this field. Please enter valid data.

Relationship to child REQUIRED Please fill out this field. Please enter valid data.

Telephone number REQUIRED

Use dashes, no spaces or parentheses/Usar guiones

Please fill out this field. Please enter a phone number.

Are you registered at St. Norbert Parish? REQUIRED Yes No Please fill out this field.