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Religious Education Registration

- Faith
  - Adult / Faith Studies
    
    Adult Studies
    Youth Studies
    
    Religious Education Registration
  - Adult Education
    
    RCIA - Rite of Christian Initiation
  - Prayer Chain
    
    Prayer Chain
  - Social Outreach
    
    Social Outreach
  - Catholic Organizations
    
    Knights of Columbus
    Catholic Daughters

The maximum number of form submissions has been reached. This form is currently not available.
- Father's Information:
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Religion
  
  Email Please enter an email address.
  
  Cell Phone Number Maximum 20 characters Please enter a phone number.
  
  Work Number Maximum 20 characters Please enter a phone number.
  
  Home Number Maximum 20 characters Please enter a phone number.
  
  Address Please enter valid data.
  
  City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
  
  Email Please enter an email address.
  
  Child Lives With
- Mother's Information
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Religion
  
  Cell Phone Number Maximum 20 characters Please enter a phone number.
  
  Work Number Maximum 20 characters Please enter a phone number.
  
  Home Phone Maximum 20 characters Please enter a phone number.
  
  Address Please enter valid data.
  
  City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
- Stepparent / Guardian's Information
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Religion
  
  Cell Phone Number Maximum 20 characters Please enter a phone number.
  
  Work Number Maximum 20 characters Please enter a phone number.
  
  Home Number Maximum 20 characters Please enter a phone number.
  
  Address Please enter valid data.
  
  City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
- Emergency Contact Information
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Relation To The Child / Children REQUIRED Please fill out this field. Please enter valid data.
  
  Cell Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Work Number Maximum 20 characters Please enter a phone number.
  
  Email Please enter an email address.
  
  Did Your Child / Children Register Last Year? Yes No
- Number of Children REQUIRED
  Please enter all information for each child/children you are registering.
  Please fill out this field.
  
  Child 1
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Birthday Please enter a date.
  
  Grade This Fall
  
  Name of School Attending Please enter valid data.
  
  Baptized Yes No
  
  If yes, in what church were they baptized and where is the church located? Please enter valid data.
  
  First Reconciliation Yes No
  
  If yes, in what church did they receive their First Reconciliation and where is the church located? Please enter valid data.
  
  First Communion Yes No
  
  If yes, in what church did they receive their First Communion and where is the church located? Please enter valid data.
  
  Medical Concerns / Issues Yes No
  
  If yes, please explain medical concerns or issues:
  
  Allergies Yes No
  
  If yes, please list the allergies they have:
  
  FIELD TRIP CONSENT & LIABILITY WAIVER
  
  I grant permission for my child(ren) to participate in religious education and youth ministry events that require transportation to a location away from the parish site. Activities will take place under the guidance and direction of parish employees and/or volunteers from St. Mary’s Church. I understand that I will be given a written description of the activity beforehand As a parent/legal guardian, I remain legally responsible for any personal actions taken by the above names minor “participant”. I agree on behalf of myself, my child(ren) names herein, my spouse and our heirs, successors, and assigns, that for the benefit of St. Mary’s Church, its officers, directors and agents, and the Diocese of Sioux City, chaperones and represetnatives associated with the event (referred to collectively as “them”), that: We release and forever discharge them from any and all claims and causes of actions that we may have against them, arising in connections with the activities of the participant child(ren) while attending an event or in connection with an illness or injury or cost of medical treatment therewith, in so much as they made reasonable efforts to maintain the safety of the child while in their care and my child has complied with all rules and instruction of the program.
  
  Do You Agree? I Agree
  
  MEDICAL MATTERS
  
  I hereby warrant to the best of my knowledge that my child(ren) I am registering is in good health, and I assume all responsibility for the health of my child(ren). In the event of an emergency, I hereby give permission to transport my child(ren) to the hospital for emergency medical or surgical treatment. I wish to be advised prior to any further treatment by the hospital or doctor.
  
  Do You Agree? I Agree
  
  Child 3
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Birthday Please enter a date.
  
  Grade This Fall
  
  Name of School Attending Please enter valid data.
  
  Baptized Yes No
  
  If yes, in what church were they baptized and where is the church located? Please enter valid data.
  
  First Reconciliation Yes No
  
  If yes, in what church did they receive their First Reconciliation and where is the church located? Please enter valid data.
  
  First Communion Yes No
  
  If yes, in what church did they receive their First Communion and where is the church located? Please enter valid data.
  
  Medical Concerns / Issues Yes No
  
  If yes, please explain medical concerns or issues:
  
  Allergies Yes No
  
  If yes, please list the allergies they have:
  
  FIELD TRIP CONSENT & LIABILITY WAIVER
  
  I grant permission for my child(ren) to participate in religious education and youth ministry events that require transportation to a location away from the parish site. Activities will take place under the guidance and direction of parish employees and/or volunteers from St. Mary’s Church. I understand that I will be given a written description of the activity beforehand As a parent/legal guardian, I remain legally responsible for any personal actions taken by the above names minor “participant”. I agree on behalf of myself, my child(ren) names herein, my spouse and our heirs, successors, and assigns, that for the benefit of St. Mary’s Church, its officers, directors and agents, and the Diocese of Sioux City, chaperones and represetnatives associated with the event (referred to collectively as “them”), that: We release and forever discharge them from any and all claims and causes of actions that we may have against them, arising in connections with the activities of the participant child(ren) while attending an event or in connection with an illness or injury or cost of medical treatment therewith, in so much as they made reasonable efforts to maintain the safety of the child while in their care and my child has complied with all rules and instruction of the program.
  
  Do You Agree? I Agree
  
  MEDICAL MATTERS
  
  I hereby warrant to the best of my knowledge that my child(ren) I am registering is in good health, and I assume all responsibility for the health of my child(ren). In the event of an emergency, I hereby give permission to transport my child(ren) to the hospital for emergency medical or surgical treatment. I wish to be advised prior to any further treatment by the hospital or doctor.
  
  Do You Agree? I Agree
  
  Child 4
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Birthday Please enter a date.
  
  Grade This Fall
  
  Name of School Attending Please enter valid data.
  
  Baptized Yes No
  
  If yes, in what church were they baptized and where is the church located? Please enter valid data.
  
  First Reconciliation Yes No
  
  If yes, in what church did they receive their First Reconciliation and where is the church located? Please enter valid data.
  
  First Communion Yes No
  
  If yes, in what church did they receive their First Communion and where is the church located? Please enter valid data.
  
  Medical Concerns / Issues Yes No
  
  If yes, please explain medical concerns or issues:
  
  Allergies Yes No
  
  If yes, please list the allergies they have:
  
  FIELD TRIP CONSENT & LIABILITY WAIVER
  
  I grant permission for my child(ren) to participate in religious education and youth ministry events that require transportation to a location away from the parish site. Activities will take place under the guidance and direction of parish employees and/or volunteers from St. Mary’s Church. I understand that I will be given a written description of the activity beforehand As a parent/legal guardian, I remain legally responsible for any personal actions taken by the above names minor “participant”. I agree on behalf of myself, my child(ren) names herein, my spouse and our heirs, successors, and assigns, that for the benefit of St. Mary’s Church, its officers, directors and agents, and the Diocese of Sioux City, chaperones and represetnatives associated with the event (referred to collectively as “them”), that: We release and forever discharge them from any and all claims and causes of actions that we may have against them, arising in connections with the activities of the participant child(ren) while attending an event or in connection with an illness or injury or cost of medical treatment therewith, in so much as they made reasonable efforts to maintain the safety of the child while in their care and my child has complied with all rules and instruction of the program.
  
  Do You Agree? I Agree
  
  MEDICAL MATTERS
  
  I hereby warrant to the best of my knowledge that my child(ren) I am registering is in good health, and I assume all responsibility for the health of my child(ren). In the event of an emergency, I hereby give permission to transport my child(ren) to the hospital for emergency medical or surgical treatment. I wish to be advised prior to any further treatment by the hospital or doctor.
  
  Do You Agree? I Agree
  
  Child 5
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Birthday Please enter a date.
  
  Grade This Fall
  
  Name of School Attending Please enter valid data.
  
  Baptized Yes No
  
  If yes, in what church were they baptized and where is the church located? Please enter valid data.
  
  First Reconciliation Yes No
  
  If yes, in what church did they receive their First Reconciliation and where is the church located? Please enter valid data.
  
  First Communion Yes No
  
  If yes, in what church did they receive their First Communion and where is the church located? Please enter valid data.
  
  Medical Concerns / Issues Yes No
  
  If yes, please explain medical concerns or issues:
  
  Allergies Yes No
  
  If yes, please list the allergies they have:
  
  FIELD TRIP CONSENT & LIABILITY WAIVER
  
  I grant permission for my child(ren) to participate in religious education and youth ministry events that require transportation to a location away from the parish site. Activities will take place under the guidance and direction of parish employees and/or volunteers from St. Mary’s Church. I understand that I will be given a written description of the activity beforehand As a parent/legal guardian, I remain legally responsible for any personal actions taken by the above names minor “participant”. I agree on behalf of myself, my child(ren) names herein, my spouse and our heirs, successors, and assigns, that for the benefit of St. Mary’s Church, its officers, directors and agents, and the Diocese of Sioux City, chaperones and represetnatives associated with the event (referred to collectively as “them”), that: We release and forever discharge them from any and all claims and causes of actions that we may have against them, arising in connections with the activities of the participant child(ren) while attending an event or in connection with an illness or injury or cost of medical treatment therewith, in so much as they made reasonable efforts to maintain the safety of the child while in their care and my child has complied with all rules and instruction of the program.
  
  Do You Agree? I Agree
  
  MEDICAL MATTERS
  
  I hereby warrant to the best of my knowledge that my child(ren) I am registering is in good health, and I assume all responsibility for the health of my child(ren). In the event of an emergency, I hereby give permission to transport my child(ren) to the hospital for emergency medical or surgical treatment. I wish to be advised prior to any further treatment by the hospital or doctor.
  
  Do You Agree? I Agree
  
  Child 6
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Birthday Please enter a date.
  
  Grade This Fall
  
  Name of School Attending Please enter valid data.
  
  Baptized Yes No
  
  If yes, in what church were they baptized and where is the church located? Please enter valid data.
  
  First Reconciliation Yes No
  
  If yes, in what church did they receive their First Reconciliation and where is the church located? Please enter valid data.
  
  First Communion Yes No
  
  If yes, in what church did they receive their First Communion and where is the church located? Please enter valid data.
  
  Medical Concerns / Issues Yes No
  
  If yes, please explain medical concerns or issues:
  
  Allergies Yes No
  
  If yes, please list the allergies they have:
  
  FIELD TRIP CONSENT & LIABILITY WAIVER
  
  I grant permission for my child(ren) to participate in religious education and youth ministry events that require transportation to a location away from the parish site. Activities will take place under the guidance and direction of parish employees and/or volunteers from St. Mary’s Church. I understand that I will be given a written description of the activity beforehand As a parent/legal guardian, I remain legally responsible for any personal actions taken by the above names minor “participant”. I agree on behalf of myself, my child(ren) names herein, my spouse and our heirs, successors, and assigns, that for the benefit of St. Mary’s Church, its officers, directors and agents, and the Diocese of Sioux City, chaperones and represetnatives associated with the event (referred to collectively as “them”), that: We release and forever discharge them from any and all claims and causes of actions that we may have against them, arising in connections with the activities of the participant child(ren) while attending an event or in connection with an illness or injury or cost of medical treatment therewith, in so much as they made reasonable efforts to maintain the safety of the child while in their care and my child has complied with all rules and instruction of the program.
  
  Do You Agree? I Agree
  
  MEDICAL MATTERS
  
  I hereby warrant to the best of my knowledge that my child(ren) I am registering is in good health, and I assume all responsibility for the health of my child(ren). In the event of an emergency, I hereby give permission to transport my child(ren) to the hospital for emergency medical or surgical treatment. I wish to be advised prior to any further treatment by the hospital or doctor.
  
  Do You Agree? I Agree
  
  Child 2
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Birthday Please enter a date.
  
  Grade This Fall
  
  Name of School Attending Please enter valid data.
  
  Baptized Yes No
  
  If yes, in what church were they baptized and where is the church located? Please enter valid data.
  
  First Reconciliation Yes No
  
  If yes, in what church did they receive their First Reconciliation and where is the church located? Please enter valid data.
  
  First Communion Yes No
  
  If yes, in what church did they receive their First Communion and where is the church located? Please enter valid data.
  
  Medical Concerns / Issues Yes No
  
  If yes, please explain medical concerns or issues:
  
  Allergies Yes No
  
  If yes, please list the allergies they have:
  
  FIELD TRIP CONSENT & LIABILITY WAIVER
  
  I grant permission for my child(ren) to participate in religious education and youth ministry events that require transportation to a location away from the parish site. Activities will take place under the guidance and direction of parish employees and/or volunteers from St. Mary’s Church. I understand that I will be given a written description of the activity beforehand As a parent/legal guardian, I remain legally responsible for any personal actions taken by the above names minor “participant”. I agree on behalf of myself, my child(ren) names herein, my spouse and our heirs, successors, and assigns, that for the benefit of St. Mary’s Church, its officers, directors and agents, and the Diocese of Sioux City, chaperones and represetnatives associated with the event (referred to collectively as “them”), that: We release and forever discharge them from any and all claims and causes of actions that we may have against them, arising in connections with the activities of the participant child(ren) while attending an event or in connection with an illness or injury or cost of medical treatment therewith, in so much as they made reasonable efforts to maintain the safety of the child while in their care and my child has complied with all rules and instruction of the program.
  
  Do You Agree? I Agree
  
  MEDICAL MATTERS
  
  I hereby warrant to the best of my knowledge that my child(ren) I am registering is in good health, and I assume all responsibility for the health of my child(ren). In the event of an emergency, I hereby give permission to transport my child(ren) to the hospital for emergency medical or surgical treatment. I wish to be advised prior to any further treatment by the hospital or doctor.
  
  Do You Agree? I Agree
Submit

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St. Mary's Catholic Church

1005 HIll Avenue, Spirit Lake, IA

Religious Education Registration