Discipleship Formation

Family Last Name(Required)

Primary Email(Required)

for sending you a receipt upon submission.

Home Parish(Required)

St. Isidore

St. Therese of Lisieux

St. Francis-St. Maximilan

Other

Address(Required)

Street Address City State ZIP Code

Parent/Guardian 1 Name(Required)

Use full name if last is different

Parent/Guardian 1 Relationship(Required)

Parent/Guardian 1 Phone(Required)

Cell preferred

Parent/Guardian 1 Email(Required)

Parent/Guardian 2 Name

Use full name if last is different

Parent/Guardian 2 Relationship

Parent/Guardian 2 Phone

Cell preferred

Parent/Guardian 2 Email

Are you a catechist or hall monitor?(Required)

Yes, I am a Catechist

Yes, I am a Hall Monitor

No

No, but interested in becoming one

Children

Child’s Name	Actions

There are no Children.

Total Children Added

Photo Release(Required)

As a parent/guardian of the child(ren) listed on this form, permission is hereby given for my child(ren) to participate in activities sponsored by St. Francis/St. Maximilian, St. Isidore and, or, St. Therese of Lisieux Parish(es). I recognize that engaging in the activities on parish grounds, or in their buildings may expose my child (ren) to the possibility of physical injury and I agree to hold St. Francis/St. Maximilian, St. Isidore and, or, St. Therese of Lisieux parish(es) harmless, as well as their employees, organizers, and any volunteers assisting in the programs, from liability and claims arising out of my child’s participation in programs subsidiaries, and related activities. As part of the education programs, pictures are occasionally taken of the students participating in activities and events. Please, indicate below whether we, the aforementioned, may include pictures of your child(ren) in our parish bulletin or on the parish web site. WE WILL NOT IDENTIFY YOUR CHILD(REN) BY NAME.

I have read and agree to the Participation Waver

No, do not use photos

One child registration

Price:

Two children registration

Price:

including 25% discount ($100/child)

Three or more registration fee

Price:

including 33% discount ($100/child)

Thanks for being a catechist! To show our appreciation, use the code “dfcatechist” below to save $100 off of your registration.”

Thanks for being a hall monitor! To show our appreciation, use the code “dfhallmonitor” below to save $50 off of your registration.”

Coupon

Total

Payment Method(Required)

American Express

Discover

MasterCard

Visa

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Discipleship Formation Registration