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REGISTRATION FORM
SAINT MICHAEL - UNION, NJ
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Family Address
Primary Family Address
Family Name
Address
Primary E-mail
This will be the main e-mail address we will use to communicate with your family.
Primary Phone
This will be the main phone number we will use to communicate with your family.
What Church do you belong to?
St. Michael's, Holy Spirit, or other. Please specify.
What Religion are you and the children?
Catholic, or other. Please specify.
Number of Children
1
2
3
4
5
Number of Children you will be registering today
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Father / Guardian
Name
Deceased
Yes
No
E-mail
Marital Status
Married
Divorced
Separated
Single
Widower
Occupation
Cell Phone
Mother / Guardian
Maiden Name
Name
Deceased
Yes
No
E-mail
Marital Status
Married
Divorced
Separated
Single
Widow
Occupation
Cell Phone
Custody Information
Who do the children live with? Are there any custody issues?
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Page Break
Child 1
Name
Gender
Male
Female
Date of Birth
School Grade
Freshman
Sophomore
Junior
Senior
School Grade in Fall 2020
Cell Phone
E-mail Address
T-shirt Size
Which Sacraments has your child received?
Baptism
Eucharist
Confirmation
Child 2
Name
Gender
Male
Female
Date of Birth
School Grade
Freshman
Sophomore
Junior
Senior
School Grade in Fall 2020
Cell Phone
E-mail Address
T-shirt Size
Which Sacraments has your child received?
Baptism
Eucharist
Confirmation
Child 3
Name
Gender
Male
Female
Date of Birth
School Grade
Freshman
Sophomore
Junior
Senior
School Grade in Fall 2020
Cell Phone
E-mail Address
T-shirt Size
Which Sacraments has your child received?
Baptism
Eucharist
Confirmation
Child 4
Name
Gender
Male
Female
Date of Birth
School Grade
Freshman
Sophomore
Junior
Senior
School Grade in Fall 2020
Cell Phone
E-mail Address
T-shirt Size
Which Sacraments has your child received?
Baptism
Eucharist
Confirmation
Child 5
Name
Gender
Male
Female
Date of Birth
School Grade
Freshman
Sophomore
Junior
Senior
School Grade in Fall 2020
Cell Phone
E-mail Address
T-shirt Size
Which Sacraments has your child received?
Baptism
Eucharist
Confirmation
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Emergency Contact
Emergency Contact Name
Relationship
Emergency Contact Phone
Terms & Conditions
I understand that in the case of injury or illness, every effort will be made to contact me in a medical emergency. In the event I cannot be reached, I give permission to parish staff to secure all proper and necessary treatment for my child(ren). I understand that no liability is assumed by the church or the Archdiocese for claims that may arise.
I agree
Parental Consent for Medical Care: In case of an emergency, I give permission for my child to receive emergency medical treatment and, if necessary, be transported to the nearest appropriate medical facility.
I agree
I understand that photos of my child(ren) may be taken and used in Parish publications including web and print media.
I agree
Total Choices
Late Fee Date
A Late Fee of $20.00 will be added after 08/15/2017
Late Fee
Total Normal
Total Amount
Verification
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SUBMIT FORM AND PAY