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St. John Neumann -
St. Isaac Jogues
Fall Registration Form
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Family Address
Are you a member of our Parish?
Yes
No
If no, at which Parish are you registered?
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.
Secondary E-mail
This is optional
Primary Phone
This will be the main phone number we will use to communicate with your family.
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Father / Guardian
Name
Living Status
Living
Deceased
E-mail
Marital Status
Married
Divorced
Separated
Single
Widower
Religion
Cell Phone
Mother / Guardian
Maiden Name
Name
Living Status
Living
Deceased
E-mail
Marital Status
Married
Divorced
Separated
Single
Widower
Religion
Cell Phone
Custody Status
Are there any custody issues we should be made aware of? Enter N/A if not applicable. Otherwise, inform us of any issues and provide a copy of Custodial Agreement if available.
Emergency Contact OTHER Than Parent/Guardian
Emergency Contact OTHER Than Parent/Guardian
Relationship
Emergency Contact Phone
In addition to the above contacts, please provide two additional persons who can pick up your child/children.
Pick up Name 1
Phone
Pick up name 2
Phone 2
Did you have a child/children who attended our 2021 Summer Program?
Yes
No
Number of Children Registering Today (Grades K-8)
1
2
3
4
5
Number of Children Registering Today (Grades K-8)*
1
2
3
4
5
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Child 1
Is your child a New or Returning Student to our program?
New Student
Returning Student
Name
Gender
Male
Female
Date of Birth
Place of Birth
City & State
FF Grade Fall 2021
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
Sixth Grade
Seventh Grade
Eighth Grade
$50 Sacramental Fee for 2nd and 8th grade students
Individualized Education Program (IEP)
Yes
No
IEP Details
If yes, please describe any learning issues or concerns.
Prescribed Medications/ Disability*/Learning Support Services/Other
Enter N/A if not applicable. Otherwise please list all pertinent medical/learning data so we can best meet the needs of your child. Include any other information that you think is important for us to know.
Child 1 Class Options
Session: 1st Choice
Sunday - Grades 1-8 - 10:15-11:30 am
Monday - Grades K-6 - 4:30-5:45 pm
Monday - Grades 7 & 8 - 6:30-7:45 pm
Tuesday - Grades 1-8 - 4:30-5:45 pm
Tuesday - Grades 7-8 - 6:30 - 7:45 pm
Session: 2nd Choice
Sunday - Grades 1-8 - 10:15-11:30 am
Monday - Grades K-6 - 4:30-5:45 pm
Monday - Grades 7 & 8 - 6:30-7:45 pm
Tuesday - Grades 1-8 - 4:30-5:45 pm
Tuesday - Grades 7-8 - 6:30 - 7:45 pm
Child 1 Sacraments
Previous Religious Education Experience
Enter N/A if not applicable. If new to this Faith Formation Program, please provide student's last grade completed and Parish Name and Address.
When registering your child for the first time, please complete the Sacraments Fields. Date and Church of Baptism is required and the Baptismal Certificate must be submitted to the FF Office. If the Sacraments of Reconciliation and Communion apply, please complete those fields as well.
Date of Baptism
Church of Baptism
Church Name, City & State
Date of Reconciliation
Church of Reconciliation
Church Name, City & State
Date of First Communion
Church of First Communion
Church Name, City & State
Child 2
Is your child a New or Returning Student to our program?
New Student
Returning Student
Name
Gender
Male
Female
Date of Birth
Place of Birth
City & State
FF Grade Fall 2021
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
Sixth Grade
Seventh Grade
Eighth Grade
$50 Sacramental Fee for 2nd and 8th grade students
Individualized Education Program (IEP)
Yes
No
IEP Details
If yes, please describe any learning issues or concerns.
Prescribed Medications/ Disability*/Learning Support Services/Other
Enter N/A if not applicable. Otherwise please list all pertinent medical/learning data so we can best meet the needs of your child. Include any other information that you think is important for us to know.
Child 2 Class Options
Session
Sunday - Grades 1-8 - 10:15-11:30 am
Monday - Grades K-6 - 4:30-5:45 pm
Monday - Grades 7 & 8 - 6:30-7:45 pm
Tuesday - Grades 1-8 - 4:30-5:45 pm
Tuesday - Grades 7-8 - 6:30 - 7:45 pm
Session - 2nd choice
Sunday - Grades 1-8 - 10:15-11:30 am
Monday - Grades K-6 - 4:30-5:45 pm
Monday - Grades 7 & 8 - 6:30-7:45 pm
Tuesday - Grades 1-8 - 4:30-5:45 pm
Tuesday - Grades 7-8 - 6:30 - 7:45 pm
Child 2 Sacraments
Previous Religious Education Experience
Enter N/A if not applicable. If new to this Faith Formation Program, please provide student's last grade completed and Parish Name and Address.
When registering your child for the first time, please complete the Sacraments Fields. Date and Church of Baptism is required and the Baptismal Certificate must be submitted to the FF Office. If the Sacraments of Reconciliation and Communion apply, please complete those fields as well.
Date of Baptism
Church of Baptism
Church Name, City & State
Date of Reconciliation
Church of Reconciliation
Church Name, City & State
Date of First Communion
Church of First Communion
Church Name, City & State
Child 3
Is your child a New or Returning Student to our program?
New Student
Returning Student
Name
Gender
Male
Female
Date of Birth
Place of Birth
City & State
FF Grade Fall 2021
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
Sixth Grade
Seventh Grade
Eighth Grade
$50 Sacramental Fee for 2nd and 8th grade students
Individualized Education Program (IEP)
Yes
No
IEP Details
If yes, please describe any learning issues or concerns.
Prescribed Medications/ Disability*/Learning Support Services/Other
Enter N/A if not applicable. Otherwise please list all pertinent medical/learning data so we can best meet the needs of your child. Include any other information that you think is important for us to know.
Child 3 Class Options
Session
Sunday - Grades 1-8 - 10:15-11:30 am
Monday - Grades K-6 - 4:30-5:45 pm
Monday - Grades 7 & 8 - 6:30-7:45 pm
Tuesday - Grades 1-8 - 4:30-5:45 pm
Tuesday - Grades 7-8 - 6:30 - 7:45 pm
Session - 2nd choice
Sunday - Grades 1-8 - 10:15-11:30 am
Monday - Grades K-6 - 4:30-5:45 pm
Monday - Grades 7 & 8 - 6:30-7:45 pm
Tuesday - Grades 1-8 - 4:30-5:45 pm
Tuesday - Grades 7-8 - 6:30 - 7:45 pm
Child 3 Sacraments
Previous Religious Education Experience
Enter N/A if not applicable. If new to this Faith Formation Program, please provide student's last grade completed and Parish Name and Address.
When registering your child for the first time, please complete the Sacraments Fields. Date and Church of Baptism is required and the Baptismal Certificate must be submitted to the FF Office. If the Sacraments of Reconciliation and Communion apply, please complete those fields as well.
Date of Baptism
Church of Baptism
Church Name, City & State
Date of Reconciliation
Church of Reconciliation
Church Name, City & State
Date of First Communion
Church of First Communion
Church Name, City & State
Child 4
Is your child a New or Returning Student to our program?
New Student
Returning Student
Name
Gender
Male
Female
Date of Birth
Place of Birth
City & State
FF Grade Fall 2021
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
Sixth Grade
Seventh Grade
Eighth Grade
$50 Sacramental Fee for 2nd and 8th grade students
Individualized Education Program (IEP)
Yes
No
IEP Details
If yes, please describe any learning issues or concerns.
Prescribed Medications/ Disability*/Learning Support Services/Other
Enter N/A if not applicable. Otherwise please list all pertinent medical/learning data so we can best meet the needs of your child. Include any other information that you think is important for us to know.
Child 4 Class Options
Session
Sunday - Grades 1-8 - 10:15-11:30 am
Monday - Grades K-6 - 4:30-5:45 pm
Monday - Grades 7 & 8 - 6:30-7:45 pm
Tuesday - Grades 1-8 - 4:30-5:45 pm
Tuesday - Grades 7-8 - 6:30 - 7:45 pm
Session - 2nd choice
Sunday - Grades 1-8 - 10:15-11:30 am
Monday - Grades K-6 - 4:30-5:45 pm
Monday - Grades 7 & 8 - 6:30-7:45 pm
Tuesday - Grades 1-8 - 4:30-5:45 pm
Tuesday - Grades 7-8 - 6:30 - 7:45 pm
Child 4 Sacraments
Previous Religious Education Experience
Enter N/A if not applicable. If new to this Faith Formation Program, please provide student's last grade completed and Parish Name and Address.
When registering your child for the first time, please complete the Sacraments Fields. Date and Church of Baptism is required and the Baptismal Certificate must be submitted to the FF Office. If the Sacraments of Reconciliation and Communion apply, please complete those fields as well.
Date of Baptism
Church of Baptism
Church Name, City & State
Date of Reconciliation
Church of Reconciliation
Church Name, City & State
Date of First Communion
Church of First Communion
Church Name, City & State
Child 5
Is your child a New or Returning Student to our program?
New Student
Returning Student
Name
Gender
Male
Female
Date of Birth
Place of Birth
City & State
FF Grade Fall 2021
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
Sixth Grade
Seventh Grade
Eighth Grade
$50 Sacramental Fee for 2nd and 8th grade students
Individualized Education Program (IEP)
Yes
No
IEP Details
If yes, please describe any learning issues or concerns.
Prescribed Medications/ Disability*/Learning Support Services/Other
Enter N/A if not applicable. Otherwise please list all pertinent medical/learning data so we can best meet the needs of your child. Include any other information that you think is important for us to know.
Child 5 Class Options
Session
Sunday - Grades 1-8 - 10:15-11:30 am
Monday - Grades K-6 - 4:30-5:45 pm
Monday - Grades 7 & 8 - 6:30-7:45 pm
Tuesday - Grades 1-8 - 4:30-5:45 pm
Tuesday - Grades 7-8 - 6:30 - 7:45 pm
Session - 2nd choice
Sunday - Grades 1-8 - 10:15-11:30 am
Monday - Grades K-6 - 4:30-5:45 pm
Monday - Grades 7 & 8 - 6:30-7:45 pm
Tuesday - Grades 1-8 - 4:30-5:45 pm
Tuesday - Grades 7-8 - 6:30 - 7:45 pm
Child 5 Sacraments
Previous Religious Education Experience
Enter N/A if not applicable. If new to this Faith Formation Program, please provide student's last grade completed and Parish Name and Address.
When registering your child for the first time, please complete the Sacraments Fields. Date and Church of Baptism is required and the Baptismal Certificate must be submitted to the FF Office. If the Sacraments of Reconciliation and Communion apply, please complete those fields as well.
Date of Baptism
Church of Baptism
Church Name, City & State
Date of Reconciliation
Church of Reconciliation
Church Name, City & State
Date of First Communion
Church of First Communion
Church Name, City & State
Document Uploads
File Upload
Add files
Drop files anywhere to add
Please upload any documents required by the office with this form. (Examples: Baptismal Certificates and Other Sacrament Certificates, Letter of Transfer, Custody Agreement, and/or Any Other)
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Volunteer Information
Are you volunteering?
No
Yes, as a Catechist (50% discount)*
Yes, as an Assistant, Session Coordinator, or Safety Monitor (25% Discount)*
Please contact Danielle Meosky for further details
Special Instructions
By not checking the box, you are granting permission for the following:
I understand that photos of my child(ren) may be taken and used in Parish and/or the Diocese publications. This includes both web and print media.
x
I don't agree
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 don't 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 medical facility.
x
I don't agree
Total Registration
Sacramental Fees
Teacher Discount
Current Date
June 30 Fee
August 31 Fee
Total Amount
NOTE: YOUR SESSION CHOICE IS NOT GUARANTEED IF PAYMENT IS NOT MADE ON THE FOLLOWING PAGE. FAILURE TO SUBMIT PAYMENT AT THIS TIME WILL REQUIRE YOU TO COMPLETE THIS REGISTRATION FORM AGAIN.
Verification
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SUBMIT FORM AND PAY