Youth Faith Formation Registration 2021-2022

Please Complete ASAP

Welcome to the Our Lady of the Hills Faith Formation Program for students in Grades K through 11 (K-1 is a child/parent, or guardian, class). We instruct any student interested in learning more about the Catholic Faith. Please reach out if you have any questions (413-268-4045 ~ Please leave a message).

Student #1 Information

Name

First Name*

Last Name*

Grade in Fall

Required*

School Attending

Required*

Gender

	Female
	Male

Other

Important Info (i.e. allergies, disabilities, etc.)

Student #2 Information

Name

First Name

Last Name

Grade in Fall

School Attending

Gender

	Female
	Male

Other

Important Info (i.e. allergies, disabilities, etc.)

Student #3 Information

Name

First Name

Last Name

Grade in Fall

School Attending

Gender

	Female
	Male

Other

Important Info (i.e. allergies, disabilities, etc.)

Student #4

Name

First Name

Last Name

Grade in Fall

School Attending

Gender

	Female
	Male

Other

Important Info (i.e. allergies, disabilities, etc.)

Home Parish

Home Parish
Required*

	Our Lady of the Hills
	Other

If Other:

1st Communion & Confirmation Students

Parish Where Baptized (inc. City, State):

*Confirmation Students

Parish received 1st Communion (inc. City, State):

Parent/Guardian #1 Contact Information

Name

First Name*

Last Name*

List (Single Choice)
Required*

	Mother
	Father
	Other

If other:

Address

Street 1*

Street 2

City*

State*

Zip*

Phone

Phone #2

E-mail

Parent/Guardian #2 Contact Information

Name

First Name

Last Name

List (Single Choice)

	Mother
	Father
	Other

If Other:

Address

Street 1

Street 2

City

State

Zip

Phone

Phone #2

E-mail

Other Contact

(please note anyone else who may be contacted in case of emergency)

Name

First Name

Last Name

Relationship

Phone

BEST CONTACT FOR CLASS INFO:

	(E-Mail, Cell/Text, House Phone, etc.)
Best One Way to Contact (E-Mail, Cell/Text, House Phone, etc.)	Required*

Notes/Comments

	Use this space for anything else you would like to add.
Text (Multiple Lines)

*REGISTRATION FEE* 2021-2022

Message	Registration Fee: $20/child; $50/family (Make check payable to: Our Lady of the Hills with “Faith Formation-name of student/s” in memo and mail to the Parish Office at: 173 Main Street, Haydenville, MA 01039-9768, or put in an envelope marked “Faith Formation” to place in the mass collection basket.) Families who are unable to help defray cost of program should speak with the Pastor or Director – no child will be refused instruction due to financial difficulties. Feel free to comment in the notes section if you’d like to speak with someone about this or be in touch in a way convenient to you.

NOTE

	*Families who are unable to help defray cost of the program should speak with the Pastor or Director - no child will be refused instruction due to financial difficulties. Feel free to comment in the notes section if you prefer.

Office purposes only:

Message	Date Rec'd:___________ Check #:_____________