<p> ST FRANCIS OF ASSISI CATHOLIC COMMUNITY RELIGIOUS EDUCATION REGISTRATION FORM 2017-2018 *PLEASE COMPLETE THIS FORM IN ITS ENTIRETY.</p><p>BASIC INFORMATION Family Last Name: ______Primary Phone: (_____) ______Father’s Name: ______Father’s Phone: (_____) ______Mother’s Name: ______Mother’s Phone: (_____) ______Family Email: ______Street Address: ______City: ______Zip Code: ______Secondary Street Address (if needed): ______City: ______Zip Code: ______If more than one address is listed should mailings be sent to both? YES NO</p><p>EMERGENGY CONTACT *Other than parent/guardian. Please note: every effort will be made to contact parents first. Emergency Contact Name: ______Emergency Contact Phone: (_____) ______Relation to Child(ren): ______</p><p>STUDENT 1 INFORMATION Name: ______Grade this year: ______Birth Date: ___/____/____ Sex: M___ F___ Health Problems/Other Conditions: ______Sacraments needed: ______STUDENT 1 ENROLLMENT CHOICE Grades 1-5 RE Wednesday 5:45-7:00 pm______Grades 6-8 Edge Wednesday 7-8:30 pm _____ Grades 9+ High School Ministry/Confirmation Prep Wednesday 7:00-8:30 pm_____</p><p>STUDENT 2 INFORMATION Name: ______Grade this year: ______Birth Date: ___/____/____ Sex: M___ F___ Health Problems/Other Conditions: ______Sacraments needed: ______STUDENT 2 ENROLLMENT CHOICE Grades 1-5 RE Wednesday 5:45-7:00 pm______Grades 6-8 Edge Wednesday 7-8:30 pm _____ Grades 9+ High School Ministry/Confirmation Prep Wednesday 7:00-8:30 pm_____</p><p>STUDENT 3 INFORMATION (additional student information can be filled out on a separate sheet and attached) Name: ______Grade this year: ______Birth Date: ___/____/____ Sex: M___ F___ Health Problems/Other Conditions: ______Sacraments needed: ______STUDENT 3 ENROLLMENT CHOICE Grades 1-5 RE Wednesday 5:45-7:00 pm______Grades 6-8 Edge Wednesday 7-8:30 pm _____ Grades 9+ High School Ministry/Confirmation Prep Wednesday 7:00-8:30 pm_____</p><p>MEDICAL LIABILTY RELEASE I, the undersigned guardian of this student participant, do hereby release, forever discharge and agree to hold harmless St. Francis of Assisi Catholic Community 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(s) that occur while the student(s) is involved in any trip or activity for which I have given him/her permission to attend. Furthermore, I, on behalf of my child(ren), do assume all risk of personal injury, sickness, death, damage and expenses as a result of participation in recreation and work activities involved therein. Furthermore, authorization and permission is given to said church to furnish any necessary transportation, food and lodging for this participant(s). I do also authorize adult workers with St. Francis of Assisi Catholic Community and its programs to consent to any examination, X-ray, anesthetic, medical, surgical diagnosis/treatment and hospital care which is deemed advisable by, and is rendered under the general or special supervision of any physician or surgeon licensed under the provisions of the Medical Practice Act on the medical staff of a licensed hospital, whether such diagnosis or treatment is rendered at the office of said physician at such hospital. I assume the responsibility of all medical bills, if any. The undersigned further agrees to hold harmless and indemnify said church, its directors, employees and adult workers for any liability sustained by said church as the result of the negligent, willful or intentional acts of said participant(s), including expenses incurred. Further, should it be necessary for the participant(s) to return home due to medical reasons, disciplinary actions or other-wise, I hereby assume all transportation costs. </p><p>Parent/Guardian Signature: ______Date:______</p><p>MEDIA AND SOCIAL NETWORKING RELEASE I, the undersigned guardian of this student participant, do understand that photographs or videos taken during religious education or youth ministry events may be used in St. Francis of Assisi Catholic Community newsletters, bulletin boards, web pages, or other publications. I also understand that, in junior high and high school youth ministries, social networking websites and tools, especially Facebook, Instagram, and text messaging are used to communicate with students. Ultimately, guardians are responsible for all internet activities of their children, but I understand that youth ministry staff persons or volunteers may use these media to communicate with my teen. </p><p>Parent/Guardian Signature: ______Date: ______</p><p>___ Please check here if you DO NOT want your child(ren)’s photograph or video to be used in St. John the Baptist publications/internet. Cost per child-RE, EDGE, HIGH SCHOOl x $85 each ______MINISTRY OR max $200 Total __ # of students enrolling in religious ed. Cost per child for a catechist/core team x $45 each member (discount of 50%) OR max $100 ______# of students enrolling in religious ed. Total DONATION (optional) I wish to add this amount to my registration $ ______towards religious education scholarship funds Grand Total </p><p>PROGRAM FEES - Please submit to Parish Office (324 E. North Ave.) or Program Coordinators before September 1st. Make checks payable to “St. Francis of Assisi.”</p><p>*Please note: No one will ever be denied religious education because of an inability to pay. Please contact the religious education office if there is a hardship for a scholarship application.</p><p>St. Francis of Assisi Catholic Community Family Commitment 2017-2018</p><p>The Catholic Church, states that “parent above others are obliged to form their children in the faith and practice of Christian life by work and example” (Can. 774). Our parish recognizes and affirms parents in their role as the primary catechists of their children. As your children were baptized, parents and godparents made a commitment to see that their child or godchild would be raised in the Catholic Faith. That is not a simple or necessarily easy task. We know that families are so very busy, so we want to help you bring discipleship into your family’s daily routine. </p><p>SPIRITUAL In additional to attending weekly Mass and on Holy Days of Obligation, we ask that your family commit to forming yourself in the faith and helping your child(ren) experience the beauty, goodness, and truth of the Church. </p><p>Please circle three ways you will commit to growing spiritually this year as a family:</p><p>Attend all Sacramental Preparation Parent Sessions (First Communion, First Reconciliation and/or Confirmation) Pray as a family at home (before meals, rosary, other devotions) Attend Parent Edge/Lifenights with your middle and/or high school student Watch a study course on FORMED.org (free with code GMP642) Read the Catechism or scripture on a daily/weekly basis Attend Adoration (offered every Monday 7-8 pm, Fridays 24 hours (Friday following 7:30 or 8:30 am Mass- Saturday 7:30 am) Serve at Mass (lector, usher, choir, gift bearers, greeters, altar servers, Extraordinary Ministers of Holy Communion, etc)</p><p>TITHE The parish is a family of families. Each of us offers unique time, talent, and treasure. Each of us is needed and valuable to the growth of our parish and our program. </p><p>Please circle three ways you will commit to helping our parish family grow over this upcoming year:</p><p>Tithe 10% of your income (or an amount your family prays and discerns they are able to) Enroll in Automatic Giving Purchase Scrip on a regular basis Attend monthly religious education council meetings Serve on the parish/finance council Serve as a catechist/core team member Donate Snacks/Materials as needed Help with office/parking lot needs, hallway aid Help with Fundraising Events for the parish (Fall Fest, Fish Fry, etc.) Volunteer at St. Vincent de Paul Assist at funeral luncheons Clean/decorate the church</p><p>Signature: ______</p>