Youth Faith Formation Registration 13-Aug-2019 19:06:28

Please Complete ASAP

Welcome to the Our Lady of the Hills Faith Formation Program for students in Grades 1 through 11. 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.)

Home Parish

Home Parish
Required*

	Our Lady of the Hills
	Other

If Other:

1st Communion Students

	(For those baptized at another parish, please call that rectory and request that the Baptismal Certificate be sent to Our Lady of the Hills)
Parish Where Baptized:

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

Notes/Comments

	(please list any allergies or learning challenges here by student name)
Text (Multiple Lines)

*REGISTRATION FEE - $20/child; $50/Family

	Checks should be made payable to: Our Lady of the Hills with "Faith Formation-name of student(s)" in memo and mailed to the Parish Office at 173 Main St, Haydenville, MA 01039 or placed in Collection basket at Mass in separate envelope indicating "Youth Faith Formation".

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 #:_____________