1706 Evans Street, Morehead City, NC 28557
252-726-3559

Faith Formation Registration

Fill Out ALL Information and Click the Submitt Button

Family Information

Date

Required* //

Parent's Name

First Name*

Last Name*

Address

Street 1*

Street 2

City*

State*

Zip*

Home Phone

Required* --

Father's Cell Phone

Mother's Cell Phone

Preferred E-mail

Physician Information

Please list the Family Dr. and His/Her Number as well as Insurance ID and Policy Number (ALL Information is Confidential.)

Emergency Contact

List the name and number of whom to contact in case of emergency if other than parent.

Child/Youth Information

Child/Youth Full Name

First Name

Last Name

Date of Birth

Grade Level

Sacraments RECEIVED

	Baptism
	Reconciliation
	First Eucharist
	Confirmation

Sacrament Preparation

	Baptism
	Reconciliation
	First Eucharist
	Confirmation

Sacrament that youth has not received and needs preparation for.

Photos 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

First Name

Last Name

Date of Birth

Grade Level

Sacraments RECEIVED

	Baptism
	Reconciliation
	First Eucharist
	Confirmation

Sacrament Preparation

	Baptism
	Reconciliation
	First Eucharist
	Confirmation

Sacrament that youth has not received and needs preparation for.

Photo's and Media Agreement

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

First Name

Last Name

Date of Birth

Grade Level

Sacraments RECEIVED

	Baptism
	Reconciliation
	First Eucharist
	Confirmation

Sacrament Preparation

	Baptism
	Reconciliation
	First Eucharist
	Confirmation

Sacrament that youth has not received and needs preparation for.

Photo's and Media Agreement

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

First Name

Last Name

Grade Level

Sacraments RECEIVED

	Baptism
	Reconciliation
	First Eucharist
	Confirmation

Sacrament Preparation

	Baptism
	Reconciliation
	First Eucharist
	Confirmation

Sacrament that youth has not received and needs preparation for.

Photo and Media Agreement

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

First Name

Last Name

Date of Birth

Grade Level

Sacraments RECEIVED

	Baptism
	Reconciliation
	First Eucharist
	Confirmation

Sacrament Preparation

	Baptism
	Reconciliation
	First Eucharist
	Confirmation

Sacrament that youth has not received and needs preparation for.

Photo's and Media Agreement

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

I can help a family in need of help with registration with a donation of:

Enter Dollar Amount.

Scholarship

Yes (I would Like Scholarship Assistance.)

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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