Faith Formation Registration

Fill Out ALL Information and Click the Submitt Button

Family Information
Date //
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Parent's Name
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Address
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Home Phone --
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Father's Cell Phone --
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Mother's Cell Phone --
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Preferred E-mail
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Physician Information
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Please list the Family Dr. and His/Her Number as well as Insurance ID and Policy Number (ALL Information is Confidential.)
Emergency Contact
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List the name and number of whom to contact in case of emergency if other than parent.
Child/Youth Information
Child/Youth Full Name
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Date of Birth //
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Grade Level
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Gender
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Sacraments RECEIVED
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Sacrament Preparation
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Sacrament that youth has not received and needs preparation for.
Photos and Media Agreement
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Clicking yes or no on this button will allow or not allow pictures and or video to be taken of your child to be used in all presentation formats of the Diocese of Raleigh and St. Egbert Parish. (A formal permission form will be made available to you before the start of faith formation.)
Medical and Allergy Information
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Please list any and all allergies including food and all medications for this child/youth. (All information is Confidential)
Child/Youth Full Name
  •  
Date of Birth //
  •  
Grade Level
  •  
Gender
  •  
Sacraments RECEIVED
  •  
Sacrament Preparation
  •  
Sacrament that youth has not received and needs preparation for.
Photo's and Media Agreement
  •  
Clicking yes or no on this button will allow or not allow pictures and or video to be taken of your child to be used in all presentation formats of the Diocese of Raleigh and St. Egbert Parish. (A formal permission form will be made available to you before the start of faith formation.)
Medical and Allergy Information
  •  
Please list any and all allergies including food and all medications for this child/youth. (All information is Confidential)
Child/Youth Full Name
  •  
Date of Birth //
  •  
Grade Level
  •  
Gender
  •  
Sacraments RECEIVED
  •  
Sacrament Preparation
  •  
Sacrament that youth has not received and needs preparation for.
Photo's and Media Agreement
  •  
Clicking yes or no on this button will allow or not allow pictures and or video to be taken of your child to be used in all presentation formats of the Diocese of Raleigh and St. Egbert Parish. (A formal permission form will be made available to you before the start of faith formation.)
Medical and Allergy Information
  •  
Please list any and all allergies including food and all medications for this child/youth. (All information is Confidential)
Child/ Youth Full Name
  •  
Grade Level
  •  
Gender
  •  
Sacraments RECEIVED
  •  
Sacrament Preparation
  •  
Sacrament that youth has not received and needs preparation for.
Photo and Media Agreement
  •  
Clicking yes or no on this button will allow or not allow pictures and or video to be taken of your child to be used in all presentation formats of the Diocese of Raleigh and St. Egbert Parish. (A formal permission form will be made available to you before the start of faith formation.)
Medical and Allergy Information
  •  
Please list any and all allergies including food and all medications for this child/youth. (All information is Confidential)
Child/ Youth Full Name
  •  
Date of Birth //
  •  
Date of Birth //
  •  
Grade Level
  •  
Gender
  •  
Sacraments RECEIVED
  •  
Sacrament Preparation
  •  
Sacrament that youth has not received and needs preparation for.
Photo's and Media Agreement
  •  
Clicking yes or no on this button will allow or not allow pictures and or video to be taken of your child to be used in all presentation formats of the Diocese of Raleigh and St. Egbert Parish. (A formal permission form will be made available to you before the start of faith formation.)
Medical and Allergy Information
  •  
Please list any and all allergies including food and all medications for this child/youth. (All information is Confidential)
Faith Formation Fee
NO family will be excluded due to inability to pay.
General Fee
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I can help a family in need of help with registration with a donation of:
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Enter Dollar Amount.
Scholarship
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No family will be excluded due to inability to pay. If you would like scholarship assistance click the button and you will be contacted as soon as possible.
Submmition
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