Faith Formation 2022/23 Registration FAMILY FORM

Catechesis of the Good Shepherd

FAMILY CONTACT INFO
Family Last Name
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Write the collective last name of the child's family
Parent Name
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Relationship to child
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Parent Phone --
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Enter the main phone number where we may reach you.
Parent Email
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ALL communications will be sent to this email address.
Parent Address
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Parent #2 Name
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Relationship to child
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Parent #2 Phone --
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Parent #2 Email
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Optional. Enter an additional email address if you would like communications sent to more than the primary address.
Emergency Contact
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In the event of an emergency and we are UNABLE TO CONTACT PARENTS OR LEGAL GUARDIANS, please provide an alternate Emergency Contact Person.
Relationship
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Briefly describe the emergency contact's relationship to your child (Neighbor, Friend, Aunt, Uncle, Grandparent etc.)
Emergency Phone --
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Please provide a phone number where we may reach your emergency contact in case of an emergency. Thank you!
ARE YOU REGISTERED AT HOLY FAMILY PARISH?
Parishioner Status
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If you are not yet a registered parishioner, or are unsure, please call the Parish Office at 425-822-0295.
PARENT ORIENTATION
Every family is required to attend one orientation session. Please sign up for one date.
Parent Orientation
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All families, new or returning, need at least one person to attend a program orientation.
FAMILY MEDICAL INFORMATION
All information on this form will be kept confidential and only used in case of medical need or emergency.
Insurance Carrier
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Policy Number
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Physician Name
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Please write the name of your child's primary care physician
Health Screening
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I agree to screen my child/children for fever and/or other health conditions prior to atrium each week.
MEDIA RELEASE
I/We the parent(s)/guardian(s) of the youth named on this form, authorize and give full consent, without limitations or reservations, to Holy Family Catholic Parish, to publish any photograph or video in which the above-named child/children appear while participating in any program associated with Holy Family Catholic Parsh and its ministries. There will be no compensation for use of any photograph or video at the time of publication or in the future.
I/We agree
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Parent/Guardian
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My typed name constitutes my electronic signature and legal consent. In the event a paper signature is required, I agree to submit the appropriate form.
Parent/Guardian #2
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