<p> St. Mary’s Basilica Children’s Faith Formation Registration Form 2015-2016</p><p>Full Name (first, Middle, Last): ______</p><p>Gender: Male or Female Date of birth: ______Place of Birth: ______</p><p>Baptized in the Roman Catholic Church? Yes No If no, which religion? _</p><p>Place of Baptism: ______Unbaptized: ______Grade: ______</p><p>Parent/Guardian Information Student lives with (circle one): Mother Father Both Grandparents Other </p><p>Father’s Name Mother’s Maiden Name Religion______Religion ______Cell phone______Cell phone______</p><p>Street Address______</p><p>City______ST AZ Zip______Home Phone______</p><p>E-mail______Do you attend Mass at St. Mary’s? Y__ N ___</p><p>Are you registered at St. Mary’s Basilica Y____N____ SACRAMENT INFORMATION Please check ONLY the Sacraments that your child HAS ALREADYRECEIVED .</p><p>Baptism First Reconciliation Confirmation First Eucharist ______</p><p>EMERGENCY INFORMATION I understand that in the event of serious injury, efforts will be made to contact parents. (Expenses for this care will be the parent’s responsibility.)</p><p>______(parent/guardian signature) date If parent cannot be reached in case of illness, please contact: </p><p>Name______Phone </p><p>TUITION INFORMATION</p><p>$45 for one child $80 for two children $35 per child if three or more </p><p>Tuition paid______New Student______Returning______</p><p>Payment would be appreciated at the time of Registration Saint Mary’s Photographic Policies Issue Date July 11, 2011 Saint Mary’s Photographic and Interview Release</p><p>Today's date: ______</p><p>I hereby grant my consent to use and release to the Saint Mary’s Basilica of Phoenix the use of my name or likeness, or my child’s name or likeness, in still pictures for parish posters, parish directory video or pictures on facebook or St. Mary’s Basilica website. These items may be used without limitation or reservation of any fee. Minors cannot consent to media interviews or waive their privacy right. These decisions must be made by Parents/guardians therefore this release form must be signed by parents/guardians when the individual is a minor.</p><p>______Student Name (Please Print Name)</p><p>______Address City State Zip</p><p>______Phone</p><p>______Signature/Parent/Guardian (if minor] Please Print Name</p><p>If address is not the same as the student </p><p>______Address City State Zip</p><p>______Phone</p><p>The purpose of this form is to allow pictures for posters, Calendar, news items, video tapes, church events, directory, Internet, World Wide Web, etc. Dear Parents,</p><p>St. Mary’s Basilica Faith Formation 2015-2016 program will begin on September 13, 2015 and it will ends on May 15, 2016. Because Mass is part of the program, children and family are to attend the 9:00 AM Mass then directly following the Mass go to the Diocesan Pastoral Center. The Diocesan Pastoral Center is located on the East side of the Basilica across the plaza. Classes will begin right after the 9:00 AM Mass until 11:30 AM </p><p>St. Mary’s Basilica Sacramental Preparation Program is a 2 year program. The first year, if your child is in the 2nd grade or older he/she will receive the sacrament of Reconciliation and then he/she will be eligible the next year for Confirmation and First Eucharist. Please bring a copy of your child’s baptism certificate and full fee when you register. Reminder: Registration days are August 9, August 16, and August 30 in the Social Hall following the 9:00am and 11:00 am Masses. </p><p>On August 30, 2015 we are going to have the safe Environment class for parents followed by a short parents’ meeting in Diocese Center (Room 159 A) following the 9:00am Mass. This class is a requirement. If you do not attend this class you will not be able to register your child in our Religious Educational program. Note: The Safe Environment class is for adults only. Child Care services will not be provided. Children under 18 years of age are not permitted during training. </p><p>Bro. Tito Garcia, OFM [email protected] Office: 602-354-2068</p>