IMMACULATE HEART OF MARY FAITH FORMATION PROGRAM 2024-2025 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 2024-2025 Faith Formation Program (Fee) First, Middle, Last Name M | F Date of Birth School Child Attends Grade Baptized YesNo Date of Baptism / Location First Confession YesNo First Communion YesNo Student Returning StudentNew Student Previous Religious Instruction? YesNo Where? Any Medical Problems/Allergies Learning Disabilities?: YesNo Δ
