Register for Faith Formation Returning FamilyNew Family(if child was not baptized at SIJ, a copy of the baptisimal certificate should be sent with payment) Family Last Name:* Address:* City:* State:* ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Zip:* Home Phone: Primary Email:* Father's Info: First/Last Name: Cell Phone: Work Phone: Mother's Info: First/Last Name: Cell Phone: Work Phone: Children live with: Both ParentsMotherFather Other Emergency Contact:* Phone:* Relationship:* Child #1 Full Name:* Grade in September 2017:* ---PreKK12345678 Birthdate:* Faith Formation Program of Choice:* ---Sunday 10:10 AMHome Study Sacramental Prep Choice: ---NoneReconciliation/Eucharist Date: Church: Baptism: 1st Reconciliation: 1st Eucharist: Previous Catholic School or Faith Formation in not at SIJ: Special Needs (medical, learning, etc.): Child #2 Full Name: Grade in September 2017: ---PreKK12345678 Birthdate: Faith Formation Program of Choice: ---Sunday 10:10 AMHome Study Sacramental Prep Choice: ---NoneReconciliation/Eucharist Date: Church: Baptism: 1st Reconciliation: 1st Eucharist: Previous Catholic School or Faith Formation in not at SIJ: Special Needs (medical, learning, etc.): Child #3 Full Name: Grade in September 2017: ---PreKK12345678 Birthdate: Faith Formation Program of Choice: ---Sunday 10:10 AMHome Study Sacramental Prep Choice: ---NoneReconciliation/Eucharist Date: Church: Baptism: 1st Reconciliation: 1st Eucharist: Previous Catholic School or Faith Formation in not at SIJ: Special Needs (medical, learning, etc.): Tuition Fees In Class Pre-Kindergarten — Grade 8 By October 1: 1 child = $65 2+ children = $105 After October 1: 1 child = $75 2+ children = $125 Home Study Pre-Kindergarten — Grade 8 By October 1: 1 child = $50 2+ children = $55 After October 1: 1 child = $65 2+ children = $80 Grade 2 Sacrament Fees Each Child: Reconciliation Prep = $25 Eucharist Prep = $25 If you have financial concerns, please contact our office. We are willing to work with you. We love our volunteers! Please select an option below if you can be involved. CatechistAssistantOffice Assistant Substitute CatechistSubstitute AssistantMusic Assistant (guitar, keyboard, singing, etc.) Preferred Grade: ---Pre Kk12345678 HOME STUDY PARENTS: I agree to periodic review meetings with myself and my child/ren. PARENTS: By registering my child/ren in the Faith Formation program, I understand that as an integral part of our Kindergarten through Grade 8 curriculum, we will be teaching Catecheses for Family Life. This age-appropriate program about Christian living, chastity, character formation, and safe environment training promotes communication between you and your child. You are encouraged to review the program materials (given out later in the year) which the catechist will be using in the classroom, as well as the materials you will receive for hoe discussion. After examining the program, if you have any questions or concerns about your child participating in this program, please contact Decon Mike Baxter at 410-665-2561 or firstname.lastname@example.org. Schedules will be sent later in the summer. Archdiocese of Baltimore Permission form and Release As parent or guardian of my son/daughter, I do hereby agree to allow my son/daughter to participate in the following event (type of event/date/time). I acknowledge receipt of the attached information sheet describing the planned activity. In consideration of the opportunity for my son/daughter to participate in the activity, the receipt and sufficiency of which are acknowledged, I knowingly and voluntarily on behalf of myself and my minor child do hereby agree to forever RELEASE, HOLD HARMLESS AND INDEMNIFY St. Isaac Jogues Roman Catholic Congregation, Inc., the Roman Catholic Archbishop of Baltimore and his successors, a Corporation Sole, and all their affiliate organizations, and respective agents, employees, officers, directors, volunteers, and any officials, referees, and other participants (the Released Parties) from any liability, claims, demands and causes of action arising out of or relating to any loss, damage or injury (including death) sustained in connection with or arising out of my son/daughter's participation in the activity. By my signature below, I acknowledge that my child's participation in the activity involves inherent risk of minor or serious injury, including permanent disability, death, and/or economic losses which might result from my child's actions or inactions, the negligence of others, the inherent risks of the activity, the rules of play, the condition of the premises, or of any equipment used. I have voluntarily elected to allow my child to participate, and I fully understand, appreciate, and hereby assume all such dangers and risks. I understand that my child's participation in said activities may require a minimum level of fitness for safe participation, and that the Released Parties do not screen, medically or otherwise, individuals that participate in the activity. I acknowledge that it is my sole responsibility to make certain that my child is physically fit and healthy enough to participate in the activity. I understand that the Released Parties do not provide medical treatment or medical, health or other insurance coverage for my child, however, I hereby grant permission for any staff member of the activity to obtain medical care from a licensed physician, hospital, or medical clinic for my son/daughter in the event that I cannot be reached. Check one of the following: I am covered by hospitalization and medical insurance under: Policy #: Issued By: I do not have medical coverage and assume responsibility for the cost of hospitalization and medical care for my son/daughter. I hereby grant permission to any staff member to provide the following over-the-counter drugs (or their generic equivalent) to my son/daughter if requested by my son/daughter (Check all that apply:) Tylenol/AcetaminophenBenadryl DiphenhydramineAdvil/ IbuprofenImodium/ AntidiarrhealNeosporin/Antibody OintmentPepto Bismol Comments regarding allergies, dietary restrictions, special needs, etc.: Parents/guardians of participants are advised that photographs or digital recordings of participants may be used in publications, websites or other materials produced from time to time by the parish/school, St. Isaac Jogues Roman Catholic Congregation, Inc. or the Archdiocese of Baltimore. (Participants will not be identified, however, without specific written consent.). Parents/guardians who do not wish their child(ren) to be photographed or digitally recorded should so notify an activity staff member. Please note that the Released Parties have no control over the use of photographs or digital recording taken by media that may be covering the event in which your child(ren) participate(s). BY SUBMITTING THIS FORM I ACKNOWLEDGE THAT I HAVE READ THE ABOVE RELEASE AGREEMENT, UNDERSTAND THAT I GIVE UP SUBSTANTIAL RIGHTS BY SUBMITTING IT, AND SUBMIT IT VOLUNTARILY.