Faith Formation Registration Form – St. Michael the Archangel Kailua-Kona, HI

CHILD'S INFORMATION

Child's Name *

First

Middle

Last

Gender *

Male
Female

Birth Date *

Current Grade

Mailing Address *

Address Line 1

Address Line 2

City

State

Zip Code

Physical Address (if different from mailing address)

Address Line 1

Address Line 2

City

State

Zip Code

PARENT/GUARDIAN INFORMATION

Farther's Name

First

Middle

Last

Father's Phone

Father's Email

Mother's Name

First

Last

Mother's Phone

SACRAMENTS ALREADY RECEIVED BY CHILD

BAPTISM Date

Name of Church of Baptism

Address of Church of Baptism

Address Line 1

Address Line 2

City

State

Zip Code

RECONCILIATION Date

Name of Church of Reconciliation

Address of Church of Reconciliation

Address Line 1

Address Line 2

City

State

Zip Code

CONFIRMATION Date

Name of Church of Confirmation

Address of Church of Confirmation

Address Line 1

Address Line 2

City

State

Zip Code

SACRAMENTAL PREPARATION REQUEST FOR CHILD

CHECK ALL THAT APPLY

Sacraments Requested

Baptism
1st Communion
Reconciliation
Confirmation

MEDICAL LIABILITY RELEASE

I, the undersigned parent/guardian of the child listed above, do hereby release, forever discharge and agree to hold harmless St. Michael the Archangel Church and the directors thereof from any and all liability, claims or demands for personal injury, sickness or death as well as property damage and expenses, of any nature whatsoever which may be incurred by the undersigned and the student participant while the student is involved in any trip or activity for which I have given him/her permission to attend.

Parent/Guardian Electronic Signature *

Date *

SAFE ENVIRONMENT PROGRAM

Parent / Guardian Consent Form: Consistent with diocesan policy, St. Michael the Archangel Parish will conduct Safe Environment Training as part of the Religious Education program. A meeting will be held before this class is conducted to provide parents an opportunity to review the safe environment materials.

Safe Environment Training Consent

Yes, I give consent for my child to participate in the Safe Environment Training
No, I do not consent for my child to participate in the Safe Environment Training

Parent Guardian Electronic Signature

Date