Faith Formation – Religious Education Registration Form

2021 -2022

St. Augustine’s Parish St. Mary of Assumption Parish

25 115th Street, Troy, NY 12182 119 Broad Street, Waterford, NY 12188

518-235-3861 518-237-3131

https://staugchurchtroy.com https://stmaryswaterford.org

Parish Faith Formation Office

518-237-3131 Ext. 23

Family Last Name:_____________________________________________________________________________

Mailing Address:______________________________________________________________________________

Home/Cell Phone:___________________Email Address:______________________________________________

What Parish are you registered? :___________________________________________

Parent(s)/Guardian(s)

Father’s Information Mother’s Information

Name:_____________________________________ Name:____________________________________________

Cell Phone:_________________________________ Cell Phone:________________________________________

Work Phone:_______________________________ Work Phone:_______________________________________

Religion:___________________________________ Religion:__________________________________________

Marital Status: Married_____Single_____Divorced____Widowed_____

Emergency Information- Please list someone other than a parent/guardian

In the event of an emergency, if we are unable to contact parent/guardian, who is to be contacted?

Name:___________________________________Relationship to child:___________________________________

Home Phone:____________________Cell Phone:___________________Work Phone:_______________________

FEES & CONSENT

Tuition for 2021 – 2022 is: $45.00 for one child- $25.00 for each additional child.

PLEASE NOTE: Payment is due with registration. Thank you.

Please include : PERMISSION & RELEASE FORM

I understand that the Parishes, Parish Employees and the Roman Catholic Diocese of Albany are not liable for

accidents or injuries which may occur on school or Church property.

PARENT SIGNATURE:___________________________DATE:________

FOR OFFICE USE ONLY: Date Rec’d________Enrolled:_____Payment:________(Check_______Cash_____)

STUDENT(S) INFORMATION

CHILD’S NAME__________________________GRADE IN 2021 - 20222______SCHOOL______________________

Male__Female__ DATE OF BIRTH___________________ CITY & STATE OF BIRTH________________________

ALLERGIES/MEDICATIONS/COMMENTS:_________________________________________________________

SACRAMENTAL INFORMATION:

Please note that we are required to maintain copies of baptismal certificates on file. If your son/daughter was not

baptized at either parish, please attach a copy of their baptismal certificate.

DATE PARISH CITY & STATE

Baptism ___________________ __________________________ ________________________________

Reconciliation___________________ __________________________ ________________________________

1st Eucharist ___________________ ___________________________ _______________________________

CHILD’S NAME__________________________GRADE IN 2021 - 2022_____SCHOOL______________________

Male___Female____DATE OF BIRTH__________________CITY & STATE OF BIRTH________________________

ALLERGIES/MEDICATIONS/COMMENTS:___________________________________________________________

DATE PARISH CITY & STATE

Baptism _____________________ ____________________________ _____________________________

Reconciliation_____________________ ____________________________ _____________________________

1st Eucharist _____________________ ____________________________ _____________________________

CHILD’S NAME___________________________GRADE IN 2021 - 2022_____SCHOOL_______________________

Male___Female____DATE OF BIRTH___________________CITY & STATE OF BIRTH_________________________

ALLERGIES/MEDICATIONS/COMMENTS:____________________________________________________________

DATE PARISH CITY & STATE

Baptism _____________________ _____________________________ ____________________________

Reconciliation _____________________ _____________________________ ____________________________

1st Eucharist _____________________ _____________________________ ____________________________