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2024-2025 Communion
First Holy Communion Registration 2024-2025
Step
1
of
8
- Parent Information
12%
Parent Information
Last Name:
(Required)
Father’s Name
(Required)
Mother’s Name:
(Required)
Please Enter Address Below
(Required)
Address Number & Street Name
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
Zip Code
Mother's Cell Phone #:
(Required)
Mother Email/Main Email (For All Communication)
(Required)
Mother's Email (if different from main email)
Father's Cell Phone #:
(Required)
Father's Email
(Required)
Children Information
How many children will be taking communion this year?
(Required)
1
2
3
Child 1 - First Name:
(Required)
Child 1 Last Name:
(Required)
Child's - Date of Birth
(Required)
MM slash DD slash YYYY
Child 1 - Grade in September
(Required)
What Grade is your child in as of September 2024? Accepting 3rd Graders and Up
3rd Grade
4th Grade
5th Grade
6th Grade+
Child 1 - Gender
(Required)
Male
Female
Location of Baptism - Child 1
(Required)
How Many Years of Catechism Attended for Child 1?
(Required)
Child #2 - First Name:
(Required)
Child #2 - Last Name:
(Required)
Child #2 - Date of Birth
(Required)
MM slash DD slash YYYY
Child 2 - Grade in September
(Required)
What Grade is your child in as of September 2023? Accepting 3rd Graders and Up
3rd Grade
4th Grade
5th Grade
6th Grade+
Child #2 - Gender
(Required)
Male
Female
Location of Baptism - Child 2
(Required)
How Many Years of Catechism Attended for Child 2?
(Required)
Child #3 - First Name:
(Required)
Child #3 - Last Name:
(Required)
Child #3 - Date of Birth
(Required)
MM slash DD slash YYYY
Child 3 - Grade in September
(Required)
What Grade is your child in as of September 2023? Accepting 3rd Graders and Up
3rd Grade
4th Grade
5th Grade
6th Grade+
Child #3 - Gender
(Required)
Male
Female
Location of Baptism - Child 3
(Required)
How Many Years of Catechism Attended for Child 3?
(Required)
Emergency Contact Information
Emergency Contact Name (Cannot be the same as parents)
(Required)
First
Last
Emergency Contact Phone Number
(Required)
Relationship to Children
(Required)
Administration & Safety Consent Form
I/ We Acknowledge and Authorize that my Child will appear on St. Joseph Chaldean Catholic Church Website/Social media or in the Parish’s Bulletin to highlight Catechism/Communion Program or even Parish life.
I/ We Acknowledge and agree to dress my Child in a modest way during Catechism Classes this year and agree to the below attire guidelines:
* Dresses and Skirts should be long enough that the knees are covered when sitting.
* Shoulders should be covered.
* Necklines should not be revealing.
* Clothing should not be too tight. Clothing is to conceal, not reveal.
* Shorts are not suitable wear for Church.
I/ We, hereby acknowledge that the Catechism School is a part of faith formation/ Catholic teaching initiatives of the Catholic Church for its faithful community, and it is not a venue to exercise any activities that are not acknowledged/ accepted/ recommended by the Catholic Church and its doctrine.
I/ We understand that, by participating in the Catechetical program, my/ our child, and I/ we (the parent(s)) are expected to follow the Catechism School procedures and conduct, reflective of Catholic values.
I/ We hereby acknowledge that authorized personnel from the Catechism School, the Parish, will use the online and virtual platforms to communicate with me/us about Catechism program for update purposes.
I/ We, hereby acknowledge that when my child is in the Catechism class, it is the responsibility of the assigned class teacher to take care of him/ her and I/ we/ our designate (who are identified or consented by the parents) will be notified of any health and safety risk identified by the class teacher.
I/ We understand and hereby agree that it is my/ our responsibility to look after my child Before & after the scheduled class hours and/or any scheduled Catechism related activity time.
I/ We hereby agree that, if my child needs to be out of the classroom and/or any scheduled Catechism activity time earlier than the scheduled time, I/ we will inform the assigned class teacher in advance and I/ we/ or a designated adult will accompany the child (if the child under the age of 12) out of the classroom or designated areas.
In case of any possible conflicts/concerns I/ we have with the Catechism functionaries, I/ we will address it in a respectful and appropriate manner, and I/ we are free to contact the Parish Priest, Catechism School Principal, or an authorized/ designated person to deal with such concerns.
I/ We hereby declare that I/ we am/are the parent(s) or guardian(s) of the child named above. I have read and understood the information provided on this form in its entirety and hereby consent to participate, being aware of all the foregoing.
Name
(Required)
First
Last
Date Signed
(Required)
MM slash DD slash YYYY
Medication Information
Child 1 Name
(Required)
First
Last
Medication Prescribed for Child 1 (Please include strength and dose) (If none please type NONE in the box below)
(Required)
Child 2 Name
(Required)
First
Last
Medication Prescribed for Child 2 (Please include strength and dose) (If none please type NONE in the box below)
(Required)
Child 3 Name
(Required)
First
Last
Medication Prescribed for Child 3 (Please include strength and dose) (If none please type NONE in the box below)
(Required)
Specific Directions, for each child below, [include exact amount to give, what time and/or often, relationship to meals, specific indications, e.g. if prn (as needed)]
(Required)
Purpose of Medication, How often and at what time (hour), Specify side effects or adverse reactions, Other instructions (including emergency situations)
Please let us know if there are any allergies and their severity for each child in the boxbelow. (If none please type the word NONE in the box below)
(Required)
Does your child(ren) have any learning challenges that would affect class performance? If no, please type NO. If yes, please explain
(Required)
Disclaimer:
I give permission for my child to receive the medication described above during communion hours. I understand that it is my responsibility to purchase and supply this medication. On behalf of my child, I absolve St. Joseph Chaldean Catholic Church, St. Thomas Diocese, and all volunteers from any and all liability whatsoever that may result from my child taking this medication during communion classes.
Parent Name
(Required)
First
Last
Date SIgned
(Required)
MM slash DD slash YYYY
Protecting God's Children
Our parish will be presenting a Child Abuse Prevention Program called “Protecting GODS Children” to all the children and youth enrolled in our parish programs. It is provided by St. Thomas Chaldean Diocese and is a part of our ongoing effort to help create and maintain a safe environment for children and to protect all children from sexual abuse. This educational program is mandated by the Conference of Catholic Bishops. As a parent you have a right to choose whether your child participates. If you have any question about the program you may contact your pastor.
PGC Consent
(Required)
(YES) I give my permission to have my child participate in the “Protecting GODS Children”
(NO) I decline to have my child participate in the “Protecting GODS Children”
I'd Like to Discuss the Program with someone for More Information
Baptism Certificate
Your Child's Baptism Certificate is Required Before the Start of Classes. You May Upload Here or Provide On the First Day.
Baptism File Upload (Optional)
Please upload and/or bring a copy of the Baptismal certificate(s) if your child(ren) were not baptized at Mart Mariam
Drop files here or
Select files
Max. file size: 100 MB.
Payment
The cost per child includes gowns, pictures, videos and books in addition to all other miscellaneous costs.
Child 1 Cost
Covers the program and basic costs to the parish.
Price:
Child 2 Cost
Covers the program and basic costs to the parish.
Price:
Child 3 Cost
Covers the program and basic costs to the parish.
Price:
If you would like to help the church out in paying the 3.5% CC fees please click YES below
YES
Credit Card Processing Fees
Price:
$6.00
Total
Credit Card Payment
Credit Card
(Required)
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2442 E. Big Beaver Rd.,Troy, MI, 48083
(248) 528-3676
saintjosephccc@gmail.com
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