Family Formation Registration

In order for your child to participate in the Family Formation program, you MUST register.

Student Information

Student's Name

First Name*

Middle Name

Last Name*

Grade entering in the fall:

Required*

Date of Birth

Required* //

Place of Birth

(City, State and Country)

Home Address

Street 1

Street 2

City

State

Zip

Phone Number

E-mail

Baptized?
Required*

	Yes
	No

If yes, please provide the date of Baptism and the name and address of the church:

First Communion?
Required*

	Yes
	No

If yes, please provide the date of First Eucharist and the name and address of the church:

Any Allergies?

Please list any allergies your child may have.

Family Information

Father's Name

First Name

Middle Name

Last Name

Mother's Name

First Name

Middle Name

Last Name

Mother's Maiden Name

Parent E-mail

Father's Phone Number

Mother's Phone Number

Registered?
Required*

	Yes
	No

Are you a registered member offering time, talent or treasure to St. Albert the Great parish?

Preferred Contact

Name

First Name

Last Name

Name of the person to contact

Relationship to Student

Phone Number

Emergency Instructions

Any special instructions in the event of an emergency.