Pre-K, Elementary, &amp; Middle School Faith Formation

Last Name REQUIRED Please fill out this field. Please enter valid data.

Mother's First Name REQUIRED Please fill out this field. Please enter valid data.

Father's First Name REQUIRED Please fill out this field. Please enter valid data.

Home Address REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Alt. Phone Number Please enter a phone number.

Email REQUIRED Please fill out this field. Please enter an email address.

Is your family registered at St. Michael's Parish? REQUIRED Please fill out this field.

Will you carpool during our Elementary/Junior High Programs? REQUIRED Please fill out this field.

If yes, please list the name(s) of the person(s) who has/have your permission to drop off and pick up your children:

Children (Please include last name if different from parents)

Number of Children to Register REQUIRED Please fill out this field.
Child 1
- Name REQUIRED Please fill out this field. Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Grade REQUIRED Please fill out this field.
- Program Attendance REQUIRED Children's Liturgy Elementary Middle School Please fill out this field.
- Sacrament(s) to be Received REQUIRED Baptism Reconciliation Eucharist Confirmation None Please fill out this field.
Child 2
- Name REQUIRED Please fill out this field. Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Grade REQUIRED Please fill out this field.
- Program Attendance REQUIRED Children's Liturgy Elementary Middle School Please fill out this field.
- Sacrament(s) to be Received REQUIRED Baptism Reconciliation Eucharist Confirmation None Please fill out this field.
Child 3
- Name REQUIRED Please fill out this field. Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Grade REQUIRED Please fill out this field.
- Program Attendance REQUIRED Children's Liturgy Elementary Middle School Please fill out this field.
- Sacrament(s) to be Received REQUIRED Baptism Reconciliation Eucharist Confirmation None Please fill out this field.
Child 4
- Name REQUIRED Please fill out this field. Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Grade REQUIRED Please fill out this field.
- Program Attendance REQUIRED Children's Liturgy Elementary Middle School Please fill out this field.
- Sacrament(s) to be Received REQUIRED Baptism Reconciliation Eucharist Confirmation None Please fill out this field.
Child 5
- Name REQUIRED Please fill out this field. Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Grade REQUIRED Please fill out this field.
- Program Attendance REQUIRED Children's Liturgy Elementary Middle School Please fill out this field.
- Sacrament(s) to be Received REQUIRED Baptism Reconciliation Eucharist Confirmation None Please fill out this field.
Child 6
- Name REQUIRED Please fill out this field. Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Grade REQUIRED Please fill out this field.
- Program Attendance REQUIRED Children's Liturgy Elementary Middle School Please fill out this field.
- Sacrament(s) to be Received REQUIRED Baptism Reconciliation Eucharist Confirmation None Please fill out this field.
Child 7
- Name REQUIRED Please fill out this field. Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Grade REQUIRED Please fill out this field.
- Program Attendance REQUIRED Children's Liturgy Elementary Middle School Please fill out this field.
- Sacrament(s) to be Received REQUIRED Baptism Reconciliation Eucharist Confirmation None Please fill out this field.
Child 8
- Name REQUIRED Please fill out this field. Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Grade REQUIRED Please fill out this field.
- Program Attendance REQUIRED Children's Liturgy Elementary Middle School Please fill out this field.
- Sacrament(s) to be Received REQUIRED Baptism Reconciliation Eucharist Confirmation None Please fill out this field.
Child 9
- Name REQUIRED Please fill out this field. Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Grade REQUIRED Please fill out this field.
- Program Attendance REQUIRED Children's Liturgy Elementary Middle School Please fill out this field.
- Sacrament(s) to be Received REQUIRED Baptism Reconciliation Eucharist Confirmation None Please fill out this field.
Child 10
- Name REQUIRED Please fill out this field. Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Grade REQUIRED Please fill out this field.
- Program Attendance REQUIRED Children's Liturgy Elementary Middle School Please fill out this field.
- Sacrament(s) to be Received REQUIRED Baptism Reconciliation Eucharist Confirmation None Please fill out this field.

PARISHONER FEES: $50.00 for one child and $90.00 for two or more children. Catechists children are free and Aides are 1/2 price ($25.00 for one child and $45.00 for two or more). **Children's Liturgy programs are FREE but registration is appreciated for our records.**

Will you be using St. Michael's SCRIP for the fees? REQUIRED Yes No Please fill out this field.

**If you are in need of further assistance with paying the family fee, please see the last page of the pdf file of this form (to the right) and if you have further questions, please contact Debbie Veneklase.

PHOTOGRAPHY RELEASE
As legal guardian, I give permission for the children listed above to participate in the ST. MICHAEL'S / ST. MARY'S FAITH FORMATION PROGRAMMING. I understand that photography and/or video of participants may be occurring during the FAITH FORMATION PROGRAMMING and may be used in promotional materials. I consent to the use of images or likenesses of aforementioned children, for promotional purposes, by ST. MICHAEL'S / ST. MARY'S PARISHES.

Do you give your consent to the Photography Release above? REQUIRED Yes No Please fill out this field.

PARENT / LEGAL GUARDIAN

Guardian Name (will serve as signature) REQUIRED Please fill out this field. Please enter valid data.

Today's Date REQUIRED Please fill out this field. Please enter a date.

Formation Medical Treatment Release Form for 2021-2022

MEDICAL TREATMENT RELEASE

As legal guardian, I hereby authorize first aid/medical treatment for the children listed above in the event of an emergency which may endanger his/her life, cause disfigurement, physical impairment, or undue discomfort if delayed. It is understood that efforts will be made to contact the persons listed on this form as soon as reasonably possible. In the event that the aforementioned requires my authorization for treatment and I cannot be reached in an emergency, I hereby give my permission to the physician selected by the activity leader to hospitalize, secure medical treatment, and/or order an injection, anesthesia or surgery for the aforementioned as deemed necessary. I understand all reasonable safety precautions will be taken at all times by the parish and its agents during Faith Formation Programming. I understand the possibility of unforeseen hazards and know the inherent possibility of risk. I agree not to hold ST. MICHAEL’S, its leaders, employees, drivers, volunteers, or the ROMAN CATHOLIC DIOCESE OF GRAND RAPIDS liable for damages, losses, diseases, or injuries incurred by the aforementioned.

This release is intended for the Medical Treatment of the person(s) listed below:

Number of Children to Register REQUIRED Please fill out this field.
Child 1
- Child/Youth Full Name REQUIRED Please fill out this field. Please enter valid data.
- List all allergies, medications and relevant information below: REQUIRED Please fill out this field.
Child 2
- Child/Youth Full Name REQUIRED Please fill out this field. Please enter valid data.
- List all allergies, medications and relevant information below: REQUIRED Please fill out this field.
Child 3
- Child/Youth Full Name REQUIRED Please fill out this field. Please enter valid data.
- List all allergies, medications and relevant information below: REQUIRED Please fill out this field.
Child 4
- Child/Youth Full Name REQUIRED Please fill out this field. Please enter valid data.
- List all allergies, medications and relevant information below: REQUIRED Please fill out this field.
Child 5
- Child/Youth Full Name REQUIRED Please fill out this field. Please enter valid data.
- List all allergies, medications and relevant information below: REQUIRED Please fill out this field.
Child 6
- Child/Youth Full Name REQUIRED Please fill out this field. Please enter valid data.
- List all allergies, medications and relevant information below: REQUIRED Please fill out this field.
Child 7
- Child/Youth Full Name REQUIRED Please fill out this field. Please enter valid data.
- List all allergies, medications and relevant information below: REQUIRED Please fill out this field.
Child 8
- Child/Youth Full Name REQUIRED Please fill out this field. Please enter valid data.
- List all allergies, medications and relevant information below: REQUIRED Please fill out this field.
Child 9
- Child/Youth Full Name REQUIRED Please fill out this field. Please enter valid data.
- List all allergies, medications and relevant information below: REQUIRED Please fill out this field.
Child 10
- Child/Youth Full Name REQUIRED Please fill out this field. Please enter valid data.
- List all allergies, medications and relevant information below: REQUIRED Please fill out this field.

Emergency Contact REQUIRED Please fill out this field. Please enter valid data.

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Family Physician REQUIRED Please fill out this field. Please enter valid data.

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Health Insurance Data:

Company REQUIRED Please fill out this field. Please enter valid data.

Policy REQUIRED Please fill out this field. Please enter valid data.

Group REQUIRED Please fill out this field. Please enter valid data.

Contract REQUIRED Please fill out this field. Please enter valid data.

This release form is completed and signed of my own free will with the sole purpose of authorizing medical treatment under emergency circumstance in my absence. I certify that I am the (check below) custodial parent / legal guardian of the minor child(ren) named above, and agree to the above terms for myself and for my minor child(ren).

I am the custodial parent / legal guardian of the minor child(ren) named above, and agree to the above teams for myself and for my minor child(ren). REQUIRED Yes No Please fill out this field.

Guardian Name (will serve as signature) REQUIRED Please fill out this field. Please enter valid data.

Today's Date REQUIRED Please fill out this field. Please enter a date.

Saint Michael's Catholic Church

Coopersville, MI

Pre-K, Elementary, & Middle School Faith Formation

Contact Us

Children's Liturgy of the Word

Classes begin on Sunday, September 26

Sunday's during the 7:30 and 9:00 Mass for children ages 3-7 years.

Elementary Faith Formation

Classes begin on Wednesday, September 22

Middle School Faith Formation

Classes begin on Sunday, September 26

Sacraments

First Holy Communion

8th Grade Communion

Register Your Child/Youth Today!

Faith Formation Registration 2021-2022

Printable Version of the Faith Formation Registration Form