Faith Formation Registration Form

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How many individuals will you be registering today?

Selected Value: 0

This is the total number of individuals that you will be registering in your family.

Number of Adults (18+) Registering for Adult Formation

Selected Value: 0

Faith formation is crucial in our mission of being active, faithful disciples of Jesus. Faith formation classes further equip us in our in our mission to give witness to God’s love and make disciples. Please select the number of adults 18 and over you will be registering for Faith Formation Classes.

Number of Children (under 18) Registering for Classes

Selected Value: 0

This is the number of children you will be registering. We have classes for grades K-12.

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Adult Formation Registration

Please register only Adults 18 and over in this section that will be attending Faith Formation Classes.

Adult Formation Class: Name (1st) *

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Last

Adult Formation Class: Name (2nd) *

First

Last

Adult Formation Class: Name (3rd) *

First

Last

Adult Formation Class: Name (4th) *

First

Last

Adult Formation Class: Name (5th) *

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Last

Adult Formation Class: Name (6th) *

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Last

Adult Formation Class: Name (7th) *

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Last

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Parent/Guardian Name *

First

Last

Phone *

Parent/Guardian Name

First

Last

Phone

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Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Email *

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Layout

Child #1

Child 1: Name *

First

Last

Date of Birth *

Grade Level (in September) *

Please list any allergies, medical or behavioral conditions, dietary restrictions, etc….

If there are any special custody arrangements, please indicate this below:

Child #2

Child 2: Name *

First

Last

Date of Birth *

Grade Level (in September) *

Please list any allergies, medical or behavioral conditions, dietary restrictions, etc….

If there are any special custody arrangements, please indicate this below:

Child #3

Child 3: Name *

First

Last

Date of Birth *

Grade Level (in September) *

Please list any allergies, medical or behavioral conditions, dietary restrictions, etc….

If there are any special custody arrangements, please indicate this below:

Child #4

Child 4: Name *

First

Last

Date of Birth *

Grade Level (in September) *

Please list any allergies, medical or behavioral conditions, dietary restrictions, etc….

If there are any special custody arrangements, please indicate this below:

Child #5

Child 5: Name *

First

Last

Date of Birth *

Grade Level (in September) *

Please list any allergies, medical or behavioral conditions, dietary restrictions, etc….

If there are any special custody arrangements, please indicate this below:

Child #6

Child 6: Name *

First

Last

Date of Birth *

Grade Level (in September) *

Please list any allergies, medical or behavioral conditions, dietary restrictions, etc….

If there are any special custody arrangements, please indicate this below:

Child #7

Child 7: Name *

First

Last

Date of Birth *

Grade Level (in September) *

Please list any allergies, medical or behavioral conditions, dietary restrictions, etc….

If there are any special custody arrangements, please indicate this below:

Child #8

Child 8: Name *

First

Last

Date of Birth *

Grade Level (in September) *

Please list any allergies, medical or behavioral conditions, dietary restrictions, etc….

If there are any special custody arrangements, please indicate this below:

Child #9

Child 9: Name *

First

Last

Date of Birth *

Grade Level (in September) *

Please list any allergies, medical or behavioral conditions, dietary restrictions, etc….

If there are any special custody arrangements, please indicate this below:

Child #10

Child 10: Name *

First

Last

Date of Birth *

Grade Level (in September) *

Please list any allergies, medical or behavioral conditions, dietary restrictions, etc….

If there are any special custody arrangements, please indicate this below:

Child #11

Child 11: Name *

First

Last

Date of Birth *

Grade Level (in September) *

Please list any allergies, medical or behavioral conditions, dietary restrictions, etc….

If there are any special custody arrangements, please indicate this below:

Child #12

Child 12: Name *

First

Last

Date of Birth *

Grade Level (in September) *

Please list any allergies, medical or behavioral conditions, dietary restrictions, etc….

If there are any special custody arrangements, please indicate this below:

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Emergency Contact (Cannot be a parent/guardian listed above): *

First

Last

Relationship to Child *

Phone *

Secondary Emergency Contact (Cannot be a parent/guardian listed above): (optional)

First

Last

Relationship to Child

Phone

Physician's Name/Clinic: *

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Parent/Guardian Media Consent and Release:

By completing and signing this Parental Media Consent and Disclaimer Form, it is understood that, as part of catechesis and education in parishes and schools, my child/children may participate in live and/or recorded electronic communications and activities, such as group email, group text messages, social media and/or audio or video conferencing (using only the specific platforms designated below).

These activities and images may be recorded and included on the official website of the Diocese, Parish or School or in social media publications, materials and campaigns, as well as in other media initiatives (e.g. print or electronic news media, newsletters, websites, fundraising, advocacy and development efforts, grant applications, and video, PowerPoint, or other electronic or communication media presentations), only in compliance with the Policy and Guidelines for the Use of Technology, Email, and Social Media and other related policies, without compensation to the child/children or parent/guardian.

Photographs, video conferences and recordings, social media messages, and other print and electronic media may be available for an indeterminate period of time, unless otherwise noted at the end of this section and/or restricted to specific groups of people: and, for a specific purpose as listed at the end of this section.

Parents/guardians who have completed and meet the Safe Environment, Training, and Background Research requirements, and have submitted the current Adult Code of Conduct to the Parish/School Safe Environment Coordinator may request to participate in videoconferencing/audio conferencing sessions involving their child/children. Parents/guardians may, at any time, request copies of materials sent to their child in connection with electronic communications.
I understand that, due to the nature of the electronic communication and media platforms, confidentiality and/or protections from unauthorized dissemination cannot be guaranteed.
I understand that any photographs, audio-video recordings will only be used by the Diocese, Parish or School in a legal manner and that in no way will my child be depicted in an unethical manner.
I verify that I am aware of, understand, and agree to comply with the Policy and Guidelines for the Use of Technology, E-Mail, and Social Media, which is available on the diocesan Child and Youth Protection webpage. Diocese Policy & Guidelines for the Use of Technology & Media
I understand that unauthorized personal (one-on-one) conversations between diocesan personnel and minors violate the Policy and Guidelines for the Use of Technology, E-Mail, and Social Media, and that I may report any concerns or violations to the Diocesan Office of Communications, Media and Publications, the Diocesan Office of Child and Youth Protection, Law Enforcement, or the Missouri Child Abuse and Neglect Hotline 800-392-3738 or 844-CAN-TELL.
This Consent and Release is effective for the current academic year, beginning July 1 and ending June 30 the following year, and may be revoked by parent/guardian at any time by written notice.

Parent/Guardian Media Consent and Release Acknowledgement:

I agree to all the conditions and guidelines above and acknowledge that this consent form applies to each child included in this registration form.

By checking this box you agree that you have read the Parental/Guardian Media and Technology Consent section above and agree to and fully understand that your child/children included on this registration form must abide by all rules governing conduct in technology and media while attending Sacred Heart’s Parish School of Religion (PSR), and that you agree to the terms in the Parental/Guardian Media and Technology Consent section above.

Restrictions/Preferences for photo/video consent:

I do not consent to my child being photographed or recorded.
I do not wish my child’s photograph to be used on the church/diocese’s website or social media.
I do not agree to the above conditions and guidelines above.

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Parental/Guardian Consent:

I fully understand that my child/children listed on this registration form must abide by all rules governing conduct and safety while attending Sacred Heart’s Parish School of Religion Faith Formation Classes. During Faith Formation Classes your child/children may participate in both outdoor and indoor activities. These activities may include water, running, exertion, games, crafts (may use hot glue gun/scissors), Bible lessons, and having snacks. Your child will also be participating in two VIRTUS Safety training classes during the Faith Formation Classes. These lessons will talk about age-appropriate topics related to safety with adults/children, warning signs of abuse, trust with safe adults, bullying, and internet safety. I, the parent or guardian, certify that the underlying child/children is able to participate in any and all of these activities. I understand and herby agree to assume all the risk which may be encountered on said activities, including activities preliminary and subsequent thereto. I do, for myself and for my child/children, hereby irrevocably and unconditionally release, acquit, and forever discharge Sacred Heart Church and its agents, employees and volunteers from any and all liabilities, actions, causes or actions, claims, expenses, obligations, and damages of any nature whatsoever, which I now have or which may arise in the future, in connection with the child/children listed in this registration form participation in the described activity or in any other associated activities including, but not limited to, any injury to the child or children or property. I give my child/children permission to attend Sacred Heart’s Parish School of Religion Faith Formation Classes 2023-2024. In case of medical emergency, I, the parent/guardian of my child/children, named on this registration form, give permission to Sacred Heart Church to obtain all necessary medical care prescribed by the nearest emergency room/walk-in clinic. This care may be given under whatever conditions are necessary to preserve life, limb, or well-being of my dependent(s).

Parental/Guardian Consent Acknowledgement: *

I agree to all the terms and conditions above and below.

By checking this box you agree that you have read the Parental/Guardian Consent paragraph and agree to and fully understand that your child/children included on this registration form must abide by all rules governing conduct and safety while attending Sacred Heart’s Parish School of Religion (PSR) and that you agree to the terms in the Parental/Guardian Consent section.

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Drop Off/ Pick Up Guidelines:

Dropping Off

All students will be dropped off between 9:05-9:15am. All students under 7th Grade will need to be escorted into the building by a parent/grandparent/guardian/sibling (9th grade or older) and dropped off in their designated classes if the teacher is in the classroom (usually teachers are in the classrooms by 9:10am). DO NOT LEAVE YOUR CHILD UNATTENDED WITHOUT ADULT SUPERVISON. No student should remain unattended in the hallway or in the classroom. The 7th/ 8th grade and high school students may come to class without an adult and may go directly to their designated classrooms after 9:05am. Siblings younger than 9th grade are not permitted to pick up/drop off their younger brothers and sisters.

Picking Up

Students are to be directly picked up from their classrooms at 10:15am by their parents/guardians/designated adult or a designated sibling (9th grade or older). All students should be picked up from PSR no later than 10:20am. Siblings younger than 9th grade are not permitted to pick up/drop off their younger brothers and sisters. The individual must be a designated adult or sibling (9th grade or older) in order to pick up the student. Teachers often have special instructions and/or information about upcoming events that are crucial for the parent(s) to know and will be able to instruct the parent(s)/older sibling when he/she picks up the student(s).

Parental/Guardian Drop Off/Pickup Acknowledgement: *

I agree to all the terms and conditions above and below.

By checking this box you agree that you have read the Drop Off/Pick Up Guidelines and agree to and fully understand that your child/children must abide by the Drop Off/ Pick Up Guidelines while attending Sacred Heart’s Parish School of Religion (PSR) Faith Formation Classes.

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Inclement Weather Guidelines:

We generally follow the Bolivar School closings when making decisions regarding snow days. However weather often comes unexpectedly on Saturday/Sunday, so we will base our decisions on current weather that has either caused or may cause imminent danger and would affect driving conditions before/during Faith Formation Classes. In this case, you will be notified by our notification system through Remind if classes are canceled. Please make sure that you sign up to receive notifications.

Sacred Heart Faith Formation Remind Notification Registration:

There are no cost associated with signing up for Remind. This is the notification system that we will use for important updates, notifications, and for inclement weather. Here are two simple ways to sign up for Remind:

Text @98881 to the number 81010

You will receive a welcome text from Remind.
If anyone has trouble with 81010, they can try texting @98881 to (563) 265-6842.

Alternative Method-Link to Download APP:

If you have a smartphone,on your iPhone or Android phone, open your web browser and go to
the following link: rmd.at/98881
Follow the instructions to sign up for Remind. You’ll be prompted to download the mobile app.

Inclement Weather Acknowledgement: *

I have read the Inclement Weather Guidelines.

By checking this box you agree that you have read above sections regarding our Inclement Weather Guidelines.

Remind Notification Registration *

I have registered for the Remind.
I am choosing not to register for Remind, and I realize that I will not be notified of inclement weather class cancelations or general cancelations or class updates/reminders.

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Mass Attendance:

We know that the Precepts of the Church state that students and their families to are to attend Mass every weekend and on all Holy Days of Obligation. Far more than a mere obligation, participation in Mass each week provides the graces needed to live family life joyfully and authentically and lays the foundation for lifelong discipleship. Sacred Heart’s Family Faith Formation Program needs these bedrock foundations and so attendance at Mass is expected and is an integral part of our program at all grade levels. A family’s commitment to Christ, as expressed through consistent presence at Mass, is the most vital piece needed to foster the seeds of faith in children.

Mass Attendance Acknowledgement: *

I have read and understand the importance of bringing my family to Mass for Weekend Mass and Holy Days.

By checking this box you acknowledge you have read and agree to attending weekend Mass and Holy Days.

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Little Way Store:

Your child can earn tickets for the Little Way Store (schedule to be given at the parent/teacher meeting). Tickets can be earned through class attendence, memorizing traditional Catholic prayers, Catholic doctrine (i.e. Corporal Works of Mercy, etc), and memorizing Bible Verses. Parents are asked to encourage their child(ren) to memorize and complete their lessons weekly in order to be able to receive tickets for the Little Way Store.

Little Way Store Incentive Program Acknowledgement: *

I have read and agree to help my child through encouragement, attendance, and with memorizing in order to help them earn tickets to spend at the Little Way Store.

By checking this box you acknowledge you have read and agree to help your child with the Incentive Program.

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Parent/Guardian who filled out form: *

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Last

Parent/Guardian Signature *

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