Nativity BVM Religious Education 2016-2017 Family Registration Form

Gender

Student Name(s): ______Grade this Fall:______M or F

Last First

Student Name(s): ______Grade this Fall:______M or F

Last First

Student Name(s): ______Grade this Fall:______M or F

Last First

Parent Guardian Contact Information

Parents/Guardians: ______Daytime Work or Cell:______

Last First (for emergency use only)

Parents/Guardians: ______Daytime Work or Cell:______

Last First

EMAIL:______Home Phone:______

MAILING ADDRESS:

______

Street or PO Box Town Zip

EMERGENCY CONTACT: ______

(Other than parent/self) Name / Relationship to student Phone Number

______

Name / Relationship to student Phone Number

Please list any health concerns we need to know about your child(ren): (include their names and any special medications, allergies, health conditions etc). ______

______

The following person/people will provide transportation for my child(ren) after classes:

Name(s): Phone Number(s):

______

Mass Attendance Convenant

I understand the impact and importance of faith and spirituality in my child’s or children’s lives. Thus, I agree to do my utmost to attend Mass every weekend either here or at another Catholic Church, with my child or children whom I have registered for CCD. I understand that weekly Mass attendance is a pre-requisite for the CCD program, because the grace received at Mass is a necessary component of my child’s or children’s spiritual formation.

______

Parent Signature Date

First Grade & New Students Only!!

Child lives with: ______

Name / Relationship to child Address Phone #

Child’s Date of Birth: ______Place of Birth: ______

Father’s Name: ______Mother’s Maiden Name: ______

Child’s Date of Baptism: ______Place of Baptism: ______

Date of 1st Communion ______Place of First Communion: ______

Volunteers Are Needed

Our program is volunteer run, prayerfully consider assisting us in of the following roles:

___ Classroom Teacher ___ Classroom Assistant

___ One on One Support ___ Substitute Teacher

___ Office Help ___ Youth Ministry Coordinator

___ Christmas Pageant Director ___ All Saints Carnival Planning

___ Help with Transportation ___ Children’s Liturgy of the Word ___ Snack Coordinator Grade ______Children’s Choir Director

___ Chaperone for Teen Events (Middle School Youth Rally, Youth Congress etc.)

___ Other (if you have a talent or workshop specialty in the Catholic Faith that you would like to share please specify)______

Tuition & Fees

The suggested tuition rates are below; Please pay what you can. If the cost causes a burden to your family please contact us. No one will ever be turned away due to inability to pay. Tuition covers the cost of student work books and learning materials only. The rest of the program is supported by the parish.

Single Rate: $40.00 per student

Family Rate: $80.00 per family

Make Checks payable to: Nativity BVM-St. Louis Parish

►This form with your payment is due back by June 1, 2016

Please return both by the above date using one of the methods below:

1.  Deliver to the parish and leave with parish secretary.

2.  Mail to: Nativity BVM-St.Louis Church, 65 Canada Street, Swanton, VT 05488

3.  Place in the offertory collection at Mass in an envelope marked: CCD Registration