This form is for Religious Education Classes (Grades 1-12) for the 2024-2025 school year. Please complete one form per

student per year registering for classes at Our Lady of the Holy Family Parish.

Student's Full Name (First, Middle & Last Name)

Student Gender

Male

Female

Date of Birth

Grade

School Attending

Baptism Information

Has the child been baptized Catholic?

Yes

No

Baptismal Certificate

First Communion Information

Has the child celebrated the sacrament of First Communion?

Yes

No

Parents Information

Mother's Full Name

Mother's Address

Mother's Phone

Mother's Email

Father's Full Name

Father's Address

Father's Phone

Father's Email

Emergency Information

If parents cannot be reached, in case of emergency, please call:

Name

Relationship

Phone

Who else is authorized to pick up this child?

Name

Relationship to Child

Medical Release & General Consent

So that we can best serve your child, please list any known conditions that we should be made aware of. (i.e. learning disabilities, allergies, medications taken (if needed during class), medical, physical, emotional, behavioral, etc.)

PHOTO OPT OUT

The program often takes photos in class or at special events sponsored by the parish. The photos may be uploaded and

posted to the parish website at times or printed in the parish Sunday bulletin. If you do not want photos of your children

posted on the website or printed in the Sunday bulletin, please note below

Single choice

I CONSENT to having my child's photo posted on the website, social media, or printed in the Sunday bulletin.

I DO NOT CONSENT to having my child's photo posted on the website, social media, or printed in the Sunday bulletin.

I request the above-named participant be allowed to attend church-related activities with Our Lady of the Holy

Family Parish.

I, the parent /guardian, do hereby give permission for him/her to attend Religious Education /Sacramental Preparation classes and to be treated for a medical emergency in my absence while participating in the Religious Education program. The adult supervisor may act as an agent in my absence. In case of accident, I do not hold the Archdiocese of Chicago, the parish (Our Lady of the Holy Family Parish), its staff, or any catechists/chaperones responsible for accident or injury. I understand that all costs incurred will be my (parent’s or legal guardian’s) responsibility. I also understand that if my student breaks any of the program rules, I (the parent or legal guardian) will be notified of all actions taken and/or may be asked to immediately pick up my child from the premises.

Check here to agree to the above

Parent / Legal Guardian (Print)

Parent / Legal Guardian Signature

Are you a Parishioner of Our Lady of the Holy Family Parish?

Yes

No

Religious Education Registration

Baptism Information

First Communion Information

Parents Information

Emergency Information

Medical Release & General Consent