Faith Formation Registration Form CAPTCHAFamily InformationFather's Name First Last Father's PhoneMother's Name First Last Maiden Mother's PhoneStatus of Parents*Choose OneMarriedSeparated / DivorcedOtherAre parents registered at St. Elizabeth Ann Seton?* Yes No Name(s) of person(s) to receive mailed information*Click the ‘+’ to add more Mailing Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Name(s) of person(s) to receive Electronic information*Click the ‘+’ to add moreNameEmailText Message Address Emergency Contact Name* First Last Relationship to Child* Contact's Phone Number*Registration Fee Per Child $30.00 per child – to cover cost of materialsStudent InformationIf your child is entering Grade 1 or is new to our program, we need to have a copy of his/her Baptismal Certificate unless he/she was Baptized at St. ElizabethStudent InformationNameGradeBaptism Date & Parish (City, ST)Eucharist Date & Parish (City, ST) Do any of the students have any medical conditions we need to know?Please include the name of the student and medical condition if applicableEmailThis field is for validation purposes and should be left unchanged.
