St. Francis of Assisi Binghamton Faith Formation Registration

Mom's Name *

First

Last

Dad's Name *

First

Last

Mailing Label - name, address, zip code *

Person other than parent who may pick up your child *

Mom's Maiden Name *

Mom's Cell Number *

Dad's Cell Number: *

Parent's Marital Status *

Emergency Phone Number *

Parent Preferred Email *

My child's photograph MAY be used on the church website *

Yes No

Child's Name *

First

Last

Sacraments Child Has Received *

Baptism Reconciliation Eucharist

Birthdate *

Grade *

School *

Child's Cell (if any) *

Child's Email (if any) *

Allergies or Special Needs *

Child's Name #2 *

First

Last

Sacraments Child Has Received #2 *

Baptism Reconciliation Eucharist

Birthdate #2 *

Grade Child # 2 *

School #2 *

Child's Cell (if any) #2 *

Child's Email (if any) #2 *

Allergies or Special Needs #2 *

Child's Name #3 *

First

Last

Sacraments Child Has Received #3 *

Baptism Reconciliation Eucharist

Birthdate #3 *

Grade Child #3 *

School #3 *

Child's Cell (if any) #3 *

Child's Email (if any) #3 *

Allergies or Special Needs #3 *

Registration Form 2017-2018
File Size:	56 kb
File Type:	pdf

Download File

St. Francis of Assisi Church Faith Formation Registration Form
Fee: $35 (individual) $70 (family)

Be sure you have filled out this form in its entirety BEFORE SUBMITTING

St. Francis of Assisi Church Faith Formation Registration Form Fee: $35 (individual) $70 (family)

Be sure you have filled out this form in its entirety BEFORE SUBMITTING

St. Francis of Assisi Church Faith Formation Registration Form
Fee: $35 (individual) $70 (family)