Mary, Queen of Peace Parish 2018 — 2019
Family Faith Formation Registration Form Registration Form for Children—Preschool through 5th Grade
Family Information
Primary Parent 1 (Guardian) Last name First Name
Want more information…. Are you interested in information on Adult preparation for the Sacrament of Confirmation? YES ____
Would like to know more about the Alpha program? Yes ____ Interested in Becoming Roman Catholic or knowing more about the Church Yes ____
Interested in having your child Baptized? Yes ___ Interested in having your child prepare for 1st Sacraments Yes ___ Interested in getting Married Or in having your Marriage blessed? Yes _____
Interested in receiving the Sacrament of Anointing of the Sick? Yes ____ If so, we are happy to help you make a connection with the right staff person...
cell #
Address City Zip
Emergency Contact:
Email 1
Are you registered at Mary, Queen of Peace Parish? Yes No
Email 2
Language spoken at home: __________________________________
Early Childhood Program (Sunday 9:00 am and 11:30am) - Littlest Disciples
For ages 3 thru Kindergarten - Children must be 3 by Aug 31, 2018 Please mark which class time
Child’s Last Name First Name M/F Birthdate 3 yr Old 4 Yr Old 5 Yr Old Kinder- 9:00 Mass 11:30 Mass
Welcome to the Children and Family Evangelization Ministries
MQP offers Faith Formation opportunities for children preschool (3 yrs old) through 5th grade. Please use this form to register
for our Early Childhood and Elementary Faith Formation Children’s programs. More information about each of these programs
is available in the Children’s Faith Formation Brochures or online on our parish website. In addition, please feel free to contact
me, Jennie Caldwell, at Children. [email protected] or telephone me at: 425-391-1178 ext. 116
Phone #:
If NO, in what parish are you registered?
If you don’t have a home parish, we would love for you to join us! May we send you a registration packet? Yes, please do No, thanks
Children’s Faith Formation Program “Building Connections” Sunday 10:20 am– 11:20 For families with children from grades 1 thru 5
Child’s Name M/F Birthdate Grade Buddy Request T-shirt size
Child’s Name M/F Birthdate Grade Buddy Request T-shirt size
Faith Formation Home Study Program (Grades 1—5) Check here We will contact you with instructions
Photography Release: By returning this form, I consent to photos taken of my child participating in MQP Children ’s Faith For-
mation Programs and activities for the purpose of sharing what we did with the parish either on our website, blog, newsletters,
posters, etc. I recognize that my child will not be identified by name in any of the photos, without my further consent. If you do
not wish to have your child pictured at all, please write your instructions attn.: [email protected]
Special Needs Information: Please let us know any special needs or challenges your child(ren) might have that may
require special attention by the program director or volunteers. Please list any identified learning disabilities, medical
conditions, allergies, ect. That would be important for us to be aware of.
Child’s name:________________________ Brief description: _____________________________________________
Parental Permission: I hereby give permission for my child/children to participate in Mary, Queen of Peace Children and Family
Ministry programs for the 2018-19 academic year. In the event of an emergency, I hereby give permission to transport my
child(ren) to a hospital for emergency medical or surgical treatment.
Parent/guardian signature: __________________________________________________ Date: ______________________
Please complete the joint Family Faith Formation Fee Form for Early Childhood thru High school Youth
Scholarships available upon request—please contact Jennie Caldwell at [email protected]
Programa de la Primera Infancia — Pequeños Discípulos Miércoles 3:30—4:30pm Solo Español
Para niños de 3 años hasta Kindergarten - Los niños deben tener 3 años antes del 31 de Agosto de 2018
Apellido del Niño Primer Nombre M/F Fecha de Nacimiento 3 Años 4 Años 5 Años Kinder
Children’s Faith Formation Program—”Building Connections” Wednesday at 3:30—4:30 pm
For families with children from grades 1 thru 5