St Patrick

Faith Formation Registration 2017-2018

All families registered in the parish have an ID number. This is your Family ID. If you do not know your ID number, please click here to send an email request.

Please complete all required fields and use the Tab key (not the Enter key) to switch fields. After you submit this form, all the information will be sent by email to the parish office. Please use your child’s full name listed on the church’s registration.

 

FAMILY CONTACT INFORMATION

* Required fields
*Family ID *Family Last Name
*Primary Email: (Re-enter Email):

*Please select one:
There are no changes to our Family Contact information.
Update our Family Contact information as indicated below.
First Name Last Name Cell Phone and Provider
Work Phone  

Father/
Guardian 1

-

May we send Text Messages
to this number?
Yes No

-


Mother/
Guardian 2

-

May we send Text Messages
to this number?
Yes No

-


Family Address:

City:
Zip: -

Primary Phone: -

Child(ren) lives with:
Both Parents (same household)
Both Parents (different households)
Mother Only
Father Only

PROGRAM OPTIONS

Coordinator
K-6 Grades

Contact: Tracey Ryan-Wiering
Phone: 319-266-8711


Home Study Program: This option is available for Grades 1-11. Please contact the above coordinator for more information.

 

STUDENT INFORMATION

Please use your child’s full name listed on the church’s registration.


First Name
Gender
Last Name   Date of Birth
Grade in 2017-18
School

Program Option

Sacraments
Received


Female Male

 



Baptism
1st Reconciliation
1st Eucharist
Confirmation
Special Needs (Allergies, Asthma, IEP)
Please contact us directly to discuss any confidential needs.

 
Student Cell Phone (To receive Youth Ministry event reminders via text message) -
May we send Text Messages to this number? Yes No


You will have the opportunity to register additional students, if needed, after submitting this form.

*PARENT/GUARDIAN CONSENT FORM AND LIABILITY WAIVER REQUIRED PERMISSIONS


This Consent Form and Liability Waiver is required for and serves both on-site programs and off-site/field trip events/activities for the stated program year. This form needs to be completed annually for each student. To obtain the needed permission, contact, emergency and medical information you are requested to supply the needed information. As the specifics of each off-site/field trip event are known you will be required to complete an Off-site/Field Trip Permission Form outlining the specifics of each activity. Please complete all sections.

*Off-site/Field Trip Consent Form and Liability Waiver

I grant permission for my child to participate in school/parish events this year that may require transportation to a location away from the school/parish site. The activities will take place under the guidance and direction of school/parish employees and/or volunteers of St Patrick.

As parent and/or legal guardian, I remain legally responsible for any personal actions taken by the above named minor (“Participant”). I agree on behalf of myself, my child named herein, or our heirs, successors, and assigns, to hold harmless and defend, its officers, director of St Patrick and agents, and the Archdiocese of Dubuque, chaperons, or representatives associated with the events, arising from or in connection with my child attending the events or in connection with any illness or injury or cost of medical treatment in connection therewith, and I agree to compensate the parish, its officers, directors and agents, and the Archdiocese of Dubuque, chaperon, or representatives associated with the events for reasonable attorney’s fees and expenses which they may incur in any action I/we may bring against them as a result of such injury or damage, unless such claim arises from the negligence of the parish/school or the Archdiocese of Dubuque.

Yes
No


*Emergency Medical Treatment Permission

I hereby warrant that to the best of my knowledge, my child is in good health, and I assume all responsibility for the health of my child. In the event of an emergency, I hereby give permission to transport my child to a hospital for emergency medical or surgical treatment. I wish to be advised prior to any further treatment by the hospital or doctor. In the event of an emergency, if you are unable to reach me at the above numbers, contact:

First Name: Last Name:
Relationship to Child: Phone: -
Family Doctor: Phone:
Family Health Plan Carrier: Policy #:
Yes
No


*Other Medical Treatment

In the event it comes to the attention of the parish/school, its officers, directors and agents, and the Archdiocese of Dubuque, chaperons, or representatives associated with the activity that my child becomes ill with symptoms such as vomiting, sore throat, fever, diarrhea, I want to be notified. If Yes, Please call: -

Yes
No


*Nonprescription Medication Permission

I hereby grant permission for nonprescription medication (such as ibuprofen, Tylenol, throat lozenges, etc.) to be given to my child in the event a condition arises after my child is already in attendance at the on site program.

Yes
No


*Allergy Information

Does this child have allergic reactions? (medications, foods, plants, insects, etc.) If yes, please provide the parish/cluster with a written listing of known allergies, reactions and directives.

Yes
No


*Asthma Information

Does this child utilize asthma or airway constricting prescription medication? If yes, please provide the parish/cluster with written information on the child’s asthma condition.

Yes
No


*Prescribed Diet Information

Does this child have a medically prescribed diet? If yes, please provide the parish/cluster with additional written information on the diet.

Yes
No


*Physical Limitations Information

Does this child have any physical limitations that require accommodations by the parish/cluster? If yes, please provide the parish/cluster with additional written information on the limitations.

Yes
No


*Other Medical Information

Does this child have any other medical conditions about which the parish/cluster should be aware? If yes, please provide the parish/cluster with additional written information on the medical conditions.

Yes
No


*Medical Release

By checking this box you authorize Saint Patrick Parish Faith Formation staff to contact any emergency medical care.
By checking this box you DO NOT authorize Saint Patrick Parish Faith Formation staff to contact any emergency medical care.



*Photo Release

It is common practice for Saint Patrick Parish to use photographs on our parish website and in parish publications.

By checking this box you give your consent for your child) to be photographed with the understanding that these photos may be used.

Check here if you do not want your child photographed. You will also need to provide a current photo of your child to the parish office.


Volunteer Opportunities

Please indicate below the areas in which you can help. Our program is successful because of our volunteers and we thank you for your support!

To view a detailed description of the Volunteer Opportunity, hover your mouse pointer over the volunteer description (next to the checkbox).


 
Catechist K-8
  • Teaches weekly lessons. All materials are provided. Catechists work in teams and have assistants.
  • Ongoing training is provided.
  • Time commitment is every week, class preparation time, and training meetings.


Grade:
I would like to teach my child's class
Yes No
Child's Name:

Catechist Aid
  • Helps the catechist during class time.
  • Older children of catechists are welcome to help in this area
    however they must be in grade 9 and above.
  • Time commitment is every week.



Substitute Catechist
  • Available on short notice to teach when another catechist is unable to teach.
  • Materials and support are provided.



Life Night Core (9-11 Catechist)
  • Facilitate weekly sessions and lead a small group
  • Materials and support provided
  • Time commitment: 16 Sunday sessions, twice a year training days and once a month planning meeting



Core Support
  • Help plan and organize food and supplies for Edge Nights, Life Nights and Youth Ministry Retreats
  • Help with Edge Concession Stand



Small Group (9th Grade)
  • Facilitate and lead 12 Wednesday sessions
  • Materials and support provided



You (10th Grade Catechist)
  • Facilitate and lead 12 Wednesday sessions
  • Materials and support provided
  • Time commitment: weekly Edge sessions, twice a year training days and lesson planning time



Confirmation Small Group (11th Grade Catechist)
  • Facilitate and lead 12 Wednesday sessions
  • Materials and support provided
  • Time commitment: weekly Edge sessions, twice a year training days and lesson planning time



Children's Liturgy of The Word
  • This person is part of a team of leaders who meet with children at the 5 p.m. Sat and 9:30 a.m. Sun Mass to hear the Gospel.
  • Materials provided.
  • Commitment depends upon number of volunteers and is scheduled by volunteers.



Tuition

Submission of this form does not guarantee placement in class. Although no one is ever turned away for inability to pay, registration will NOT be processed until some form of payment has been received or alternate payment has been set up.

Fee Schedules: Early Registration After May 17 After July 31
Grade K-11 $75 per child $100 per child $125 per child
Family Cap $225 $300 $375

Grade 12 $FREE $FREE $FREE

My Tuition Worksheet

Number of K-11 Children registering:



Please record this total.

Payment Method:

You must select one of the following:
    
Please make checks payable to St. Patrick Parish and mail to:
St. Patrick Parish

Attn: Faith Formation
705 Main Street
Cedar Falls, IA 50613


    
Click the "Pay Now" button after submitting your registration


    
A member of the Faith Formation Staff will contact you with further details


    
A member of the Faith Formation Staff will contact you with further details

Entering your name and date below is the equivalent of your signed authorization.
Enter full name I am the legal
parent or guardian
of the child(ren)
being registered
Enter today's date
(mm/dd/yyyy)