IMMACULATE HEART OF MARY FAITH FORMATION PROGRAM 2019-2020 Registration Form Child Children’s Last Name: Father: Religion: Marital Status: MarriedSingleDivorced Father’s Address: Father’s Zip: Father’s Email: Father’s Phone: Mother: Religion: Marital Status: MarriedSingleDivorced Check if Same as Father’s Address: YesNo Mother’s Address: Mother’s Zip: Mother’s Email: Mother’s Phone: Emergency Contact: Phone: Please List All Children Enrolling In the 2020-2021 Faith Formation Program (Fee) First, Middle, Last Name M | F Date of Birth School Child Attends Grade Baptized YesNo First Confession YesNo First Communion YesNo Student Returning StudentNew Student Previous Religious Instruction? YesNo Where? Any Medical Problems/Allergies Learning Disabilities?: YesNo Δ
