Faith Formation Registration Form

Faith Formation Tuition
Tuition for Contributing Parishioners :
One Child - $200
Two or more children- $300

Tuition for non- Parishioners or non -Contributing Parishioners :One child -$250or more children-$400

Faith Formation Fees:
First Communion: $50
Confirmation:$90
8th Grade: $90
7th Grade $50

A $50 Late Fee will be applied to all re- registrations received after June 5 , 2024

Registration Process will be complete once payment is received or payment plan is initiated.
Permissions - Please respond to each question

This form must be filled out completely in order to register for Faith Formation. Please read all instructions carefully. Please update us if any of this information changes.

Family Name: REQUIRED Please fill out this field. Please enter valid data.

Email REQUIRED Please fill out this field. Please enter an email address.

Family Address: REQUIRED Please fill out this field. Please enter valid data.

P.O.Box Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Mother's Name: REQUIRED Please fill out this field. Please enter valid data.

Mother's Phone Number: REQUIRED Please fill out this field. Please enter valid data.

Mother's Maiden Name REQUIRED Please fill out this field. Please enter valid data.

Mother's Religion: REQUIRED Please fill out this field. Please enter valid data.

Father's Name : REQUIRED Please fill out this field. Please enter valid data.

Father's Religion : REQUIRED Please fill out this field. Please enter valid data.

Father's Phone Number: REQUIRED Please fill out this field. Please enter valid data.

Please enter all children below.

Number of Children REQUIRED Please fill out this field.
Student Name 1
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Where did your child attend Faith Formation last year? REQUIRED Please fill out this field. Please enter valid data.
- Grade REQUIRED Please fill out this field. Please enter valid data.
- What school will your child attend in 2024-2025 REQUIRED Please fill out this field. Please enter valid data.
- 2024-25 Grade in School/ 2024-2025 grade in Faith Formation REQUIRED Please fill out this field. Please enter valid data.
- If your child is new to the program, list the Church and Date of Baptism REQUIRED Please fill out this field. Please enter valid data.
- Please submit a copy of your child's Baptismal Certificate ASAP.
- Please choose your child's class session REQUIRED
  9th Grade Confirmation
  Tuesday Grades 5&6 Wednesday Grades 1-6 Tuesday 7th Grade Tuesday 8th Grade Confirmation 9th Grade Confirmation Please fill out this field.
Student Name 2
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Where did your child attend Faith Formation last year? REQUIRED Please fill out this field. Please enter valid data.
- Grade REQUIRED Please fill out this field. Please enter valid data.
- What school will your child attend in 2024-2025 REQUIRED Please fill out this field. Please enter valid data.
- 2024-25 Grade in School/ 2024-2025 grade in Faith Formation REQUIRED Please fill out this field. Please enter valid data.
- If your child is new to the program, list the Church and Date of Baptism REQUIRED Please fill out this field. Please enter valid data.
- Please submit a copy of your child's Baptismal Certificate ASAP.
- Please choose your child's class session REQUIRED
  9th Grade Confirmation
  Tuesday Grades 5&6 Wednesday Grades 1-6 Tuesday 7th Grade Tuesday 8th Grade Confirmation 9th Grade Confirmation Please fill out this field.
Student Name 3
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Where did your child attend Faith Formation last year? REQUIRED Please fill out this field. Please enter valid data.
- Grade REQUIRED Please fill out this field. Please enter valid data.
- What school will your child attend in 2024-2025 REQUIRED Please fill out this field. Please enter valid data.
- 2024-25 Grade in School/ 2024-2025 grade in Faith Formation REQUIRED Please fill out this field. Please enter valid data.
- If your child is new to the program, list the Church and Date of Baptism REQUIRED Please fill out this field. Please enter valid data.
- Please submit a copy of your child's Baptismal Certificate ASAP.
- Please choose your child's class session REQUIRED
  9th Grade Confirmation
  Tuesday Grades 5&6 Wednesday Grades 1-6 Tuesday 7th Grade Tuesday 8th Grade Confirmation 9th Grade Confirmation Please fill out this field.
Student Name 4
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Where did your child attend Faith Formation last year? REQUIRED Please fill out this field. Please enter valid data.
- Grade REQUIRED Please fill out this field. Please enter valid data.
- What school will your child attend in 2024-2025 REQUIRED Please fill out this field. Please enter valid data.
- 2024-25 Grade in School/ 2024-2025 grade in Faith Formation REQUIRED Please fill out this field. Please enter valid data.
- If your child is new to the program, list the Church and Date of Baptism REQUIRED Please fill out this field. Please enter valid data.
- Please submit a copy of your child's Baptismal Certificate ASAP.
- Please choose your child's class session REQUIRED
  9th Grade Confirmation
  Tuesday Grades 5&6 Wednesday Grades 1-6 Tuesday 7th Grade Tuesday 8th Grade Confirmation 9th Grade Confirmation Please fill out this field.
Student Name 5
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Where did your child attend Faith Formation last year? REQUIRED Please fill out this field. Please enter valid data.
- Grade REQUIRED Please fill out this field. Please enter valid data.
- What school will your child attend in 2024-2025 REQUIRED Please fill out this field. Please enter valid data.
- 2024-25 Grade in School/ 2024-2025 grade in Faith Formation REQUIRED Please fill out this field. Please enter valid data.
- If your child is new to the program, list the Church and Date of Baptism REQUIRED Please fill out this field. Please enter valid data.
- Please submit a copy of your child's Baptismal Certificate ASAP.
- Please choose your child's class session REQUIRED
  9th Grade Confirmation
  Tuesday Grades 5&6 Wednesday Grades 1-6 Tuesday 7th Grade Tuesday 8th Grade Confirmation 9th Grade Confirmation Please fill out this field.
Student Name 6
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Where did your child attend Faith Formation last year? REQUIRED Please fill out this field. Please enter valid data.
- Grade REQUIRED Please fill out this field. Please enter valid data.
- What school will your child attend in 2024-2025 REQUIRED Please fill out this field. Please enter valid data.
- 2024-25 Grade in School/ 2024-2025 grade in Faith Formation REQUIRED Please fill out this field. Please enter valid data.
- If your child is new to the program, list the Church and Date of Baptism REQUIRED Please fill out this field. Please enter valid data.
- Please submit a copy of your child's Baptismal Certificate ASAP.
- Please choose your child's class session REQUIRED
  9th Grade Confirmation
  Tuesday Grades 5&6 Wednesday Grades 1-6 Tuesday 7th Grade Tuesday 8th Grade Confirmation 9th Grade Confirmation Please fill out this field.

Please select a payment option REQUIRED I will pay in full with cash or check I will pay using WeShare (https://saintstanislaus.churchgiving.com) Please fill out this field.

Permission - Please respond to each question.

I give my permission for St. Stanislaus Kostka Faith Formation Program to photograph or videotape my child/children to be used for internal purposes. Pictures/video will not be released to the public without specific consent. REQUIRED Yes No Please fill out this field.

I give my permission for my child/children to use the internet for research and/or assignments. REQUIRED Yes No Please fill out this field.

I give permission for my phone number to be given to the CRISIS PHONE PPERSON for his/her class to used in an emergency. Checking NO may hinder our reaching you in an emergency. REQUIRED Yes No Please fill out this field.

You will automastically be signed up for Flocknote, our parish Communication System. Please call the Parish office if you have any questions.

Please sign and date REQUIRED Please fill out this field. Please enter valid data.

STUDENT EMERGENCY CONTACT FORM
Please fill out the form below with all of the requested information.

Family Last Name REQUIRED Please fill out this field. Please enter valid data.

Phone Number REQUIRED Please fill out this field. Please enter valid data.

Family Home Address REQUIRED Please fill out this field. Please enter valid data.

Mother's Name REQUIRED Please fill out this field. Please enter valid data.

Mother's Cell Phone Number REQUIRED Please fill out this field. Please enter valid data.

Father's Name REQUIRED Please fill out this field. Please enter valid data.

Father's Cell Phone Number REQUIRED Please fill out this field. Please enter valid data.

Please list all children enrolled in the faith Formation Program and any allergies , medical conditions or special needs. Please indicate if there are none. REQUIRED Please fill out this field.

Please indicate if each child has any modifications in place in school that you think may benefit them in Faith Formation as well. Please include any other information that may help us ensure that each child has a positive experience this year. REQUIRED Please fill out this field.

If the parent cannot be reached, the following person should be contacted:

Name/ Relationship REQUIRED Please fill out this field. Please enter valid data.

Phone Number/ Alternate Phone Number REQUIRED Please fill out this field. Please enter valid data.

Doctor's Name / Phone Number REQUIRED Please fill out this field. Please enter valid data.

The following people are authorized to pick up my child(ren) from faith Formation: REQUIRED Please fill out this field. Please enter valid data.

In case of accident or illness, I request that the representative of the Parish Faith Formaation Program contact me. If I am unable to be reached, I authorize the representative to call the physician indicated and to follow the phsician's instructions. If it is impossible to contact the physicain, the representative of the program may make whatever arrangements seem necessary. I agree to assume the financial responsibilty for any diagnosis, treatment and/or medication deemed necessary.
To the best of my knowledge all information given is accurate and complete. I hereby consent to and authorize the necessary procedures that have been stated above.

Signature / Date REQUIRED Please fill out this field. Please enter valid data.

St. Stanislaus Kostka Church

A Roman Catholic Parish in Pleasant Valley, NY

Faith Formation Registration Form