Faith Formation Registration

MARY, MOTHER OF MANKIND CHURCH

FAITH FORMATION REGISTRATION FORM

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MARY MOTHER OF MANKIND CHURCH

25, 4th Street, North providence, RI 02911, Ph. 401-231-3542

 

Religious Education Registration Form

PLEASE PRINT CLEARLY AND FILL IN ALL REQUESTED INFORMATION 

 

STUDENT’S FULL NAME: _____________________________________________________________________                    

LAST                                                    FIRST                                                MIDDLE IN FULL


PRESENT AGE: ______ GENDER: M__  F___  BIRTHDATE:____/____/______  Home Phone #____________________                                                                     

                                                                                                                M /D/YEAR    

 

___________________________________________________________________________________________________________________                    

Street                                                               City                                            State                          Zip Code

 

CHECK THE LEVEL YOU WISH TO ENROLL YOUR CHILD:

_____Pre-Communion                                   _____FIRST COMMUNION*  
*To enroll your child in the First Communion Program, he/she must have completed Level 1 (Pre-Communion). Also, attach to this completed form, a copy of your child’s Baptismal Certificate.

If your child is not baptized, please see our Pastor, Rev. TJ Varghese. 

_____Level 3         _____Level 4                    _____Level 5                _____Level 6  

            _____Pre-Confirmation                                 _____CONFIRMATION**     

**To enroll your child in the Confirmation Program, he/she must have completed Pre-Confirmation. Also, attached to this completed form, a copy of your child’s Baptismal and First Communion Certificate. If your child has not received one or both sacraments, please see Fr. TJ Varghese 

There will also be a separate sacramental fee for First Communion & Confirmation.

 

Family Data: (PLACE A √ IN THE BOXES BELOW IF THE INFORMATION IS THE SAME AS THE STUDENT’S ABOVE.)

 

__________________________________________________                                      ______________________________________________________             

Mother’s Name/Legal Guardian (Mrs., Ms., Miss)                                      Father’s Name/Legal Guardian Title (Mr.)

 

      Street ______________________________________________________________________________________           

      City, St., Zip ________________________________________________________________________________             

      Home Phone#______________________________________________________________________________               

      Cell Phone#________________________________________________________________________________                      

      E-Mail ______________________________________________________________________________________              

     Maiden Name _____________________________________________________________________________

 

If applicant is not living with both parents, to whom and at what address should mail be sent. (No P.O. BOXES)

___MOTHER   ___FATHER 

ADDRESS: _____________________________________ __________________________________________________________________________________________________________________                   

                               NUMBER AND STREET                                                            CITY                                              STATE                              ZIP CODE   

 

Location & Times of Classes ~ all classes will take place in the parish Hall

  • Levels 1-6 will meet Sundays from 9:00AM to 10:00AM.
  • Levels 7-10 will meet Sundays from 11:15pm SHARP – 12:15PM.
  • Students in the Religious Education Program are required to attend Mass weekly.
  • If a student attends another church, he/she needs to bring a signed bulletin to his/her next class.

 

Registration Fees ~ The registration fee for the 2022-2023 school year is $40.00 per student, not to exceed $75.00 per family. Please make checks payable to Mary Mother of Mankind Church and attach it to this completed form(s). This fee is for the purchase of books and materials needed in educating your child. If you are unable to meet this fee because of genuine hardship, please talk to Fr. TJ Varghese. This will not be a barrier to enrolling your child in religious education. 

IN CASE OF AN EMERGENCY, IF WE ARE UNABLE TO CONTACT YOU, WHOM SHOULD WE CONTACT? 

NAME____________________________________________________________________________________ 

RELATION TO STUDENT_________________________   Cell__________________________ 

Please list all the adults (including parents) authorized to pick up your child.  Your child will not be released to any other adult who is not listed below:   

_________________________________________________________________________________________________________________              

Emergency Name#1                                                                  Relationship 

Phone #________________________                                        Cell#_________________________ 

_____________________________________________              __________________________________ 

Emergency Name#2                                                                  Relationship 

Phone #______________________________                                        Cell#_________________________ 

_______________________________________________________________________________________________              

Emergency Name#3                                                                  Relationship 

Phone #________________________                                        Cell#_________________________ 

STUDENT MEDICAL INFORMATION Allergies___________________________________________________________________________________________ 

Physical Disabilities: _________________________________________________________________________________ 

Learning Disabilities: ________________________________________________________________________________

~ Photo Image Consent Form ~

I, the undersigned, do hereby give permission or not to Mary mother of Mankind Parish and the Religious Education Program to use, publish, display, and/or reproduce any video/recorded voice/digital media, photographs of my son/daughter in promotional materials for Mary mother of Mankind Parish and the Religious Education Program.  (Please circle one)

I/we DO give permission for_________________________ or DO NOT give permission for_______________________ 

  Child’s full name                                                                                           Child’s full name 

to use an image/photograph/video clip/voice as described above. We are willing to release this into the public domain for promotional purposes and understand that no monetary compensation will be given for its use.  

 

Parent/Guardian _________________________________________    Parent/Guardian _________________________________                                         

                                                           Print Name                                                                                                          Signature

 

                                                                                                                                                                                    Date___________ 

                  

 

Special Note: All students participating in the Religious Education Program must provide a copy of the certificates of the    

                      sacraments they have received thus far if you have not yet done so.

 

                                                                              

FOR OFFICE USE ONLY

BAPTISMAL RECORD         YES (    ) NO (    )  DATE__________

1st PENANCE            YES (   ) NO (    ) DATE__________ 1st COMMUNION RECORD YES (    ) NO (    )  DATE__________  REGISTRATION FEE  YES (    ) NO (    ) FEES W/____________/____ 

AMOUNT PAID___________ CK. #__________ CASH __________                  RECD. BY ______           DATE_________