EFF/MFF (1st-7th grade ONLY)
Student Registration

- Faith Formation

This Registration Page is ALL Students who are enrolling for St. Bart's EFF/MFF Program.
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- Parent First Name REQUIRED Please fill out this field. Please enter valid data.
- Last Name REQUIRED Please fill out this field. Please enter valid data.
- Student Name REQUIRED Please fill out this field. Please enter valid data.
- Student Last Name (if different from parent last name) Please enter valid data.
- Street Address REQUIRED Please fill out this field. Please enter valid data.
- City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
- Parent Email REQUIRED Please fill out this field. Please enter an email address.
- Parent Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.
- Number of Children Being Registered REQUIRED
  Number of Additional Children
  Please fill out this field.
  
  Child 1
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Student Date of Birth (ie 01-01-05) REQUIRED Please fill out this field. Please enter valid data.
  
  Did your child attend EFF/MFF classes at St. Bart's last year? yes no
  
  Student City and State of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Church, City and State of Baptism REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Baptism (ie 01-01-05) REQUIRED Please fill out this field. Please enter valid data.
  
  Godparents REQUIRED Please fill out this field. Please enter valid data.
  
  Date of First Eucharist (NA if not applicable) REQUIRED Please fill out this field. Please enter valid data.
  
  Church, City and State of First Eucharist (NA if not applicable) REQUIRED Please fill out this field. Please enter valid data.
  
  School you child attends REQUIRED Please fill out this field.
  
  What grade will your child be in the fall of 2018 1st 2nd 3rd 4th 5th 6th 7th
  
  What EFF/MFF class will they be attending REQUIRED Please fill out this field.
  
  Child 2
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Student Date of Birth (ie 01-01-05) REQUIRED Please fill out this field. Please enter valid data.
  
  Did your child attend EFF/MFF classes at St. Bart's last year? yes no
  
  Student City and State of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Church, City and State of Baptism REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Baptism (ie 01-01-05) REQUIRED Please fill out this field. Please enter valid data.
  
  Godparents REQUIRED Please fill out this field. Please enter valid data.
  
  Date of First Eucharist (NA if not applicable) REQUIRED Please fill out this field. Please enter valid data.
  
  Church, City and State of First Eucharist (NA if not applicable) REQUIRED Please fill out this field. Please enter valid data.
  
  School you child attends REQUIRED Please fill out this field.
  
  What grade will your child be in the fall of 2018 1st 2nd 3rd 4th 5th 6th 7th
  
  What EFF/MFF class will they be attending REQUIRED Please fill out this field.
  
  Child 3
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Student Date of Birth (ie 01-01-05) REQUIRED Please fill out this field. Please enter valid data.
  
  Did your child attend EFF/MFF classes at St. Bart's last year? yes no
  
  Student City and State of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Church, City and State of Baptism REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Baptism (ie 01-01-05) REQUIRED Please fill out this field. Please enter valid data.
  
  Godparents REQUIRED Please fill out this field. Please enter valid data.
  
  Date of First Eucharist (NA if not applicable) REQUIRED Please fill out this field. Please enter valid data.
  
  Church, City and State of First Eucharist (NA if not applicable) REQUIRED Please fill out this field. Please enter valid data.
  
  School you child attends REQUIRED Please fill out this field.
  
  What grade will your child be in the fall of 2018 1st 2nd 3rd 4th 5th 6th 7th
  
  What EFF/MFF class will they be attending REQUIRED Please fill out this field.
  
  Child 4
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Student Date of Birth (ie 01-01-05) REQUIRED Please fill out this field. Please enter valid data.
  
  Did your child attend EFF/MFF classes at St. Bart's last year? yes no
  
  Student City and State of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Church, City and State of Baptism REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Baptism (ie 01-01-05) REQUIRED Please fill out this field. Please enter valid data.
  
  Godparents REQUIRED Please fill out this field. Please enter valid data.
  
  Date of First Eucharist (NA if not applicable) REQUIRED Please fill out this field. Please enter valid data.
  
  Church, City and State of First Eucharist (NA if not applicable) REQUIRED Please fill out this field. Please enter valid data.
  
  School you child attends REQUIRED Please fill out this field.
  
  What grade will your child be in the fall of 2018 1st 2nd 3rd 4th 5th 6th 7th
  
  What EFF/MFF class will they be attending REQUIRED Please fill out this field.
  
  Child 5
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Student Date of Birth (ie 01-01-05) REQUIRED Please fill out this field. Please enter valid data.
  
  Did your child attend EFF/MFF classes at St. Bart's last year? yes no
  
  Student City and State of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Church, City and State of Baptism REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Baptism (ie 01-01-05) REQUIRED Please fill out this field. Please enter valid data.
  
  Godparents REQUIRED Please fill out this field. Please enter valid data.
  
  Date of First Eucharist (NA if not applicable) REQUIRED Please fill out this field. Please enter valid data.
  
  Church, City and State of First Eucharist (NA if not applicable) REQUIRED Please fill out this field. Please enter valid data.
  
  School you child attends REQUIRED Please fill out this field.
  
  What grade will your child be in the fall of 2018 1st 2nd 3rd 4th 5th 6th 7th
  
  What EFF/MFF class will they be attending REQUIRED Please fill out this field.
- ONLY IF CHILDREN ARE ATTENDING DIFFERENT DAYS - Please list name, grade and day (i.e. Andrea 5th, Tues)
- Are you a parishioner REQUIRED Please fill out this field.
- If you would like to become a registered Parishioner please click here: Registration
- PERMISSION, MEDICAL RELEASE AND WAIVER FORM
- Commitment: We, the parents or guardians of the participant/s above, give our permission to participate in all activities of Faith Formation. We accept to help our son/daughter (s) to participate actively, cooperate and follow the directions of their Catechists. We agree that if our son/daughter (s) were to have an accident as a result of participation in Catechesis, including transportation (which is not caused by negligence of the parish or their representatives), the necessary resources for care, hospital, medical and other expenses or payments will be made against the insurance company that represents us.
- Electronic Signature (Your full name) REQUIRED Please fill out this field. Please enter valid data.
- Electronic Signature REQUIRED MOTHER FATHER GUARDIAN Please fill out this field.
- CONSENT FOR IMAGE PUBLICATION REQUIRED Yes, I give permission to have my child/s picture on the St. Bartholomew's Catholic Church Website, www.barts.org, and/or in Parish publications and/or displays. Children will not be identified by name. No, I do not give my permission Please fill out this field.
- EMERGENCY CONTACT NAME REQUIRED Please fill out this field. Please enter valid data.
- EMERGENCY CONTACT EMAIL REQUIRED Please fill out this field. Please enter an email address.
- EMERGENCY CONTACT PHONE NUMBER REQUIRED Please fill out this field. Please enter a phone number.
- SPECIFIC MEDICAL INFORMATION
- Allergy Reactions (to medication, foods, Insects, etc) REQUIRED Please fill out this field.
- Current Medications; please list by child REQUIRED Please fill out this field.
- Any other medical issues to be aware of? REQUIRED Please fill out this field.
- Any special learning or physical needs? REQUIRED Please fill out this field.
- Physician Name REQUIRED Please fill out this field. Please enter valid data.
- Physician Phone Number REQUIRED Please fill out this field. Please enter a phone number.
- Dentist Name REQUIRED Please fill out this field. Please enter valid data.
- Dentist Phone Number REQUIRED Please fill out this field. Please enter a phone number.
- Medical Insurance Carrier REQUIRED Please fill out this field. Please enter valid data.
- Medical Insurance Card Number REQUIRED Please fill out this field. Please enter valid data.
- I, the parent/legal guardian of the student mentioned above, give the OFFICE OF FAITH FORMATION OF ST. BARTHOLOMEW'S the authorization to contact the contacts mentioned above. I understand and assume all responsibility for emergency care and for transport of the student mentioned above.
- Electronic Signature (Full Name) REQUIRED Please fill out this field. Please enter valid data.
- Electronic Signature REQUIRED Mother Father Guardian Please fill out this field.
Submit

EFF/MFF (1st-7th grade ONLY) Student Registration

EFF/MFF (1st-7th grade ONLY)
Student Registration