Foundations in Faith (FIF) first year 2018-19 English

PARENTS' NAME(First and Last Names) REQUIRED Please fill out this field. Please enter valid data.

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.

Email Please enter an email address.

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

1. Student's Name (First and Last) REQUIRED Please fill out this field.

Place of birth and Date of birth REQUIRED Please fill out this field. Please enter valid data.

Name of School and Grade in 2018-2019 REQUIRED Please fill out this field. Please enter valid data.

Which Sacraments has this student received

Father's Name (First, Middle, Last) REQUIRED Please fill out this field. Please enter valid data.

Father's Place of Birth (City, State, Country) and Date of Birth Please enter valid data.

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

Which sacraments has father received REQUIRED Please fill out this field.

Mother's Name: (First, Middle, Last. Include maiden name) REQUIRED Please fill out this field. Please enter valid data.

Mother's place of birth (City, State, Country) And Date of Birth REQUIRED Please fill out this field. Please enter valid data.

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

Which sacraments has Mother received REQUIRED Please fill out this field.

Do parents reside in the same house Yes No

Father's Marital Status

Mother's Marital Status

Program Fees 1 child $60 2 children $100 3 children $120 4 children 130 $10 additional late fee if paying after 10/28/2018

For your convenience you can pay through the online link on our website. If paying by check please make it payable to Shrine of St. Padre Pio and make note FIF in the memo area.

Shrine of St. Padre Pio Catholic Church
PARENT/GUARDIAN PERMISSION AND LIABILITY WAIVER

I grant permission for my child/children to participate in the Catholic Education Program (CEP) at the Shrine of St. Padre Pio Catholic Church. The CEP program will take place under the guidance and direction of parish employees and/or volunteers from the Shrine of St. Padre Pio Catholic Church. I also consent to the use of any videotapes, photographs, slide, audiotapes, or any other visual or audio reproduction with which my child/children may appear. I understand that these materials are being used for the promotion of the Shrine of St. Padre Pio Catholic Church. Such promotional activities extend to the recruitment, fund-raising, advocacy etc.

As parent/legal guardian, I remain legally responsible for any personal action taken by my child/children. I agree on behalf of myself, my child/children, our heirs, successors, and assigns to hold harmless and defend the Shrine of St. Padre Pio Catholic Church, its officers, directors, agents, and the Archdiocese of San Antonio from any liability for illness, injury or death arising for or in connection with my child’s/children’s attending the CEP program. I release the staff, volunteers, etc. from any liability connected with the use of picture or voice recordings as a part of any of the CEP activities, and I agree to compensate the parish, its officers, directors and agents, and the Archdiocese of San Antonio, or representatives associated with the event for reasonable attorney’s fees and expenses arising in connection therewith.

MEDICAL CONSENT AND PERMISSION TO TREAT
In the event of an emergency, I give permission to transport my child/children to a hospital for emergency treatment.
I am giving medical permission and consent to treat. To the best of my knowledge, my child/children is/are in good health, and I assume all responsibility for the health of my child/children.
Please include a photocopy of your Insurance card, front and back.

I Agree to the above statement regarding consent and release of information Please select this field.

I have read the online parent handbook available online Please select this field.

I Agree to pay the program fee and to sign the parent covenant agreement. Please select this field.

Please submit a new form online for additional children

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

Shrine of St.Padre Pio Catholic Church

San Antonio, TX

3843 Bulverde Pkwy

San Antonio, TX 78259

Office Hours 8:00 am-3:30 pm.

Foundations in Faith (FIF) first year 2018-19 English

Foundations in Faith 2018-19 Registration Form