BEST family email address REQUIRED

Please give the BEST email for your family.

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

Mailing 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.

I am a REGISTERED Parishioner of: REQUIRED Holy Rosary Rosenberg St. Wenceslaus Other Catholic Church I am Not Registered Anywhere Please fill out this field.

If Registered at ANOTHER Parish, Please Name the Catholic Church: Please enter valid data.

Father's Information

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

Last Name REQUIRED Please fill out this field. Please enter valid data.
Email REQUIRED Please fill out this field. Please enter an email address.
Cell Phone REQUIRED Please fill out this field. Please enter valid data.
Are texts OK? REQUIRED Yes No Please fill out this field.
Religion REQUIRED Please fill out this field. Please enter valid data.

Mother's Information

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

Last Name REQUIRED Please fill out this field. Please enter valid data.
Email REQUIRED Please fill out this field. Please enter an email address.
Cell Phone REQUIRED Please fill out this field. Please enter valid data.
Are texts OK? REQUIRED Yes No Please fill out this field.
Religion REQUIRED Please fill out this field. Please enter valid data.

Are there any family circumstances we should be aware of? (guardianship, divorce, death of parent, living with relatives): REQUIRED Please fill out this field.

Emergency Contact

Emergency Contact other than Father or Mother listed above. This person will only be contacted in emergency.
First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.
Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
Relationship and other notes REQUIRED Please fill out this field. Please enter valid data.

Number of students to enroll in Faith Formation/Youth Ministry REQUIRED Please fill out this field.
Student 1
- Student's Name REQUIRED Please fill out this field. Please enter valid data.
- I would like to register this student for Faith Formation/Youth Ministry for the following grade: REQUIRED Please fill out this field.
- Gender REQUIRED Male Female Please fill out this field.
- Date of Birth REQUIRED Please fill out this field. Please enter valid data.
- Grade in school REQUIRED Please fill out this field.
- Name of School REQUIRED Please fill out this field. Please enter valid data.
- Student's e-mail (required for students in 6th grade and older) Write "elem" for elementary students. REQUIRED Please fill out this field. Please enter valid data.
- Student's cell (required for 6th grade students and older) Write "ELEM" for elementary students. REQUIRED Please fill out this field. Please enter valid data.
- Are texts okay for 6th Grade students and older? Yes No
- Did student attend Faith Formation/Youth Ministry last year? (this is especially important during Sacramental Formation which requires two years) REQUIRED Yes No Please fill out this field.
- Location of Faith Formation/Youth Ministry last year? REQUIRED Holy Rosary Holy Rosary Catholic School Catholic High School Home Schooled - please show proof of Curriculum or Work Completed Other Please fill out this field.
- Name of School or Church IF NOT Holy Rosary Please enter valid data.
- Student has received the following Sacraments: REQUIRED Baptism Reconciliation Communion Confirmation none Please fill out this field.
- Church of BAPTISM REQUIRED Please fill out this field. Please enter valid data.
- **New Students: Please submit copy of Baptismal Certificate.
  
  **Students Receiving Sacraments This Year (First Communion or Confirmation): PLEASE CONFIRM that I already have your Baptismal Certificate, or email/deliver a Copy to me or the Front Office.
- Are there any accommodations we need to take into consideration for this student to excel in a group/educational setting that would help the staff meet their needs? (medical needs, learning or physical needs, mental health needs, etc) REQUIRED Please fill out this field.
- Medical Condition Information
  
  Archdiocesean personnel will take reasonable care to see that the following information will be held in confidence
- Student has/had any of the following medical conditions: check any that apply REQUIRED Siezures Asthma Diabetic Food allergies Depression Anxiety Autism Spectrum ADD/ADHD Has an IEP in school Has a behavior plan in school Had surgery in the last six months Still under a doctor's care for recent surgery Has a medically prescribed diet Has physical limitations none Please fill out this field.
Student 2
- Student's Name REQUIRED Please fill out this field. Please enter valid data.
- I would like to register this student for Faith Formation/Youth Ministry for the following grade: REQUIRED Please fill out this field.
- Gender REQUIRED Male Female Please fill out this field.
- Date of Birth REQUIRED Please fill out this field. Please enter valid data.
- Grade in school REQUIRED Please fill out this field.
- Name of School REQUIRED Please fill out this field. Please enter valid data.
- Student's e-mail (required for students in 6th grade and older) Write "elem" for elementary students. REQUIRED Please fill out this field. Please enter valid data.
- Student's cell (required for 6th grade students and older) Write "ELEM" for elementary students. REQUIRED Please fill out this field. Please enter valid data.
- Are texts okay for 6th Grade students and older? Yes No
- Did student attend Faith Formation/Youth Ministry last year? (this is especially important during Sacramental Formation which requires two years) REQUIRED Yes No Please fill out this field.
- Location of Faith Formation/Youth Ministry last year? REQUIRED Holy Rosary Holy Rosary Catholic School Catholic High School Home Schooled - please show proof of Curriculum or Work Completed Other Please fill out this field.
- Name of School or Church IF NOT Holy Rosary Please enter valid data.
- Student has received the following Sacraments: REQUIRED Baptism Reconciliation Communion Confirmation none Please fill out this field.
- Church of BAPTISM REQUIRED Please fill out this field. Please enter valid data.
- **New Students: Please submit copy of Baptismal Certificate.
  
  **Students Receiving Sacraments This Year (First Communion or Confirmation): PLEASE CONFIRM that I already have your Baptismal Certificate, or email/deliver a Copy to me or the Front Office.
- Are there any accommodations we need to take into consideration for this student to excel in a group/educational setting that would help the staff meet their needs? (medical needs, learning or physical needs, mental health needs, etc) REQUIRED Please fill out this field.
- Medical Condition Information
  
  Archdiocesean personnel will take reasonable care to see that the following information will be held in confidence
- Student has/had any of the following medical conditions: check any that apply REQUIRED Siezures Asthma Diabetic Food allergies Depression Anxiety Autism Spectrum ADD/ADHD Has an IEP in school Has a behavior plan in school Had surgery in the last six months Still under a doctor's care for recent surgery Has a medically prescribed diet Has physical limitations none Please fill out this field.
Student 3
- Student's Name REQUIRED Please fill out this field. Please enter valid data.
- I would like to register this student for Faith Formation/Youth Ministry for the following grade: REQUIRED Please fill out this field.
- Gender REQUIRED Male Female Please fill out this field.
- Date of Birth REQUIRED Please fill out this field. Please enter valid data.
- Grade in school REQUIRED Please fill out this field.
- Name of School REQUIRED Please fill out this field. Please enter valid data.
- Student's e-mail (required for students in 6th grade and older) Write "elem" for elementary students. REQUIRED Please fill out this field. Please enter valid data.
- Student's cell (required for 6th grade students and older) Write "ELEM" for elementary students. REQUIRED Please fill out this field. Please enter valid data.
- Are texts okay for 6th Grade students and older? Yes No
- Did student attend Faith Formation/Youth Ministry last year? (this is especially important during Sacramental Formation which requires two years) REQUIRED Yes No Please fill out this field.
- Location of Faith Formation/Youth Ministry last year? REQUIRED Holy Rosary Holy Rosary Catholic School Catholic High School Home Schooled - please show proof of Curriculum or Work Completed Other Please fill out this field.
- Name of School or Church IF NOT Holy Rosary Please enter valid data.
- Student has received the following Sacraments: REQUIRED Baptism Reconciliation Communion Confirmation none Please fill out this field.
- Church of BAPTISM REQUIRED Please fill out this field. Please enter valid data.
- **New Students: Please submit copy of Baptismal Certificate.
  
  **Students Receiving Sacraments This Year (First Communion or Confirmation): PLEASE CONFIRM that I already have your Baptismal Certificate, or email/deliver a Copy to me or the Front Office.
- Are there any accommodations we need to take into consideration for this student to excel in a group/educational setting that would help the staff meet their needs? (medical needs, learning or physical needs, mental health needs, etc) REQUIRED Please fill out this field.
- Medical Condition Information
  
  Archdiocesean personnel will take reasonable care to see that the following information will be held in confidence
- Student has/had any of the following medical conditions: check any that apply REQUIRED Siezures Asthma Diabetic Food allergies Depression Anxiety Autism Spectrum ADD/ADHD Has an IEP in school Has a behavior plan in school Had surgery in the last six months Still under a doctor's care for recent surgery Has a medically prescribed diet Has physical limitations none Please fill out this field.
Student 4
- Student's Name REQUIRED Please fill out this field. Please enter valid data.
- I would like to register this student for Faith Formation/Youth Ministry for the following grade: REQUIRED Please fill out this field.
- Gender REQUIRED Male Female Please fill out this field.
- Date of Birth REQUIRED Please fill out this field. Please enter valid data.
- Grade in school REQUIRED Please fill out this field.
- Name of School REQUIRED Please fill out this field. Please enter valid data.
- Student's e-mail (required for students in 6th grade and older) Write "elem" for elementary students. REQUIRED Please fill out this field. Please enter valid data.
- Student's cell (required for 6th grade students and older) Write "ELEM" for elementary students. REQUIRED Please fill out this field. Please enter valid data.
- Are texts okay for 6th Grade students and older? Yes No
- Did student attend Faith Formation/Youth Ministry last year? (this is especially important during Sacramental Formation which requires two years) REQUIRED Yes No Please fill out this field.
- Location of Faith Formation/Youth Ministry last year? REQUIRED Holy Rosary Holy Rosary Catholic School Catholic High School Home Schooled - please show proof of Curriculum or Work Completed Other Please fill out this field.
- Name of School or Church IF NOT Holy Rosary Please enter valid data.
- Student has received the following Sacraments: REQUIRED Baptism Reconciliation Communion Confirmation none Please fill out this field.
- Church of BAPTISM REQUIRED Please fill out this field. Please enter valid data.
- **New Students: Please submit copy of Baptismal Certificate.
  
  **Students Receiving Sacraments This Year (First Communion or Confirmation): PLEASE CONFIRM that I already have your Baptismal Certificate, or email/deliver a Copy to me or the Front Office.
- Are there any accommodations we need to take into consideration for this student to excel in a group/educational setting that would help the staff meet their needs? (medical needs, learning or physical needs, mental health needs, etc) REQUIRED Please fill out this field.
- Medical Condition Information
  
  Archdiocesean personnel will take reasonable care to see that the following information will be held in confidence
- Student has/had any of the following medical conditions: check any that apply REQUIRED Siezures Asthma Diabetic Food allergies Depression Anxiety Autism Spectrum ADD/ADHD Has an IEP in school Has a behavior plan in school Had surgery in the last six months Still under a doctor's care for recent surgery Has a medically prescribed diet Has physical limitations none Please fill out this field.
Student 5
- Student's Name REQUIRED Please fill out this field. Please enter valid data.
- I would like to register this student for Faith Formation/Youth Ministry for the following grade: REQUIRED Please fill out this field.
- Gender REQUIRED Male Female Please fill out this field.
- Date of Birth REQUIRED Please fill out this field. Please enter valid data.
- Grade in school REQUIRED Please fill out this field.
- Name of School REQUIRED Please fill out this field. Please enter valid data.
- Student's e-mail (required for students in 6th grade and older) Write "elem" for elementary students. REQUIRED Please fill out this field. Please enter valid data.
- Student's cell (required for 6th grade students and older) Write "ELEM" for elementary students. REQUIRED Please fill out this field. Please enter valid data.
- Are texts okay for 6th Grade students and older? Yes No
- Did student attend Faith Formation/Youth Ministry last year? (this is especially important during Sacramental Formation which requires two years) REQUIRED Yes No Please fill out this field.
- Location of Faith Formation/Youth Ministry last year? REQUIRED Holy Rosary Holy Rosary Catholic School Catholic High School Home Schooled - please show proof of Curriculum or Work Completed Other Please fill out this field.
- Name of School or Church IF NOT Holy Rosary Please enter valid data.
- Student has received the following Sacraments: REQUIRED Baptism Reconciliation Communion Confirmation none Please fill out this field.
- Church of BAPTISM REQUIRED Please fill out this field. Please enter valid data.
- **New Students: Please submit copy of Baptismal Certificate.
  
  **Students Receiving Sacraments This Year (First Communion or Confirmation): PLEASE CONFIRM that I already have your Baptismal Certificate, or email/deliver a Copy to me or the Front Office.
- Are there any accommodations we need to take into consideration for this student to excel in a group/educational setting that would help the staff meet their needs? (medical needs, learning or physical needs, mental health needs, etc) REQUIRED Please fill out this field.
- Medical Condition Information
  
  Archdiocesean personnel will take reasonable care to see that the following information will be held in confidence
- Student has/had any of the following medical conditions: check any that apply REQUIRED Siezures Asthma Diabetic Food allergies Depression Anxiety Autism Spectrum ADD/ADHD Has an IEP in school Has a behavior plan in school Had surgery in the last six months Still under a doctor's care for recent surgery Has a medically prescribed diet Has physical limitations none Please fill out this field.
Student 6
- Student's Name REQUIRED Please fill out this field. Please enter valid data.
- I would like to register this student for Faith Formation/Youth Ministry for the following grade: REQUIRED Please fill out this field.
- Gender REQUIRED Male Female Please fill out this field.
- Date of Birth REQUIRED Please fill out this field. Please enter valid data.
- Grade in school REQUIRED Please fill out this field.
- Name of School REQUIRED Please fill out this field. Please enter valid data.
- Student's e-mail (required for students in 6th grade and older) Write "elem" for elementary students. REQUIRED Please fill out this field. Please enter valid data.
- Student's cell (required for 6th grade students and older) Write "ELEM" for elementary students. REQUIRED Please fill out this field. Please enter valid data.
- Are texts okay for 6th Grade students and older? Yes No
- Did student attend Faith Formation/Youth Ministry last year? (this is especially important during Sacramental Formation which requires two years) REQUIRED Yes No Please fill out this field.
- Location of Faith Formation/Youth Ministry last year? REQUIRED Holy Rosary Holy Rosary Catholic School Catholic High School Home Schooled - please show proof of Curriculum or Work Completed Other Please fill out this field.
- Name of School or Church IF NOT Holy Rosary Please enter valid data.
- Student has received the following Sacraments: REQUIRED Baptism Reconciliation Communion Confirmation none Please fill out this field.
- Church of BAPTISM REQUIRED Please fill out this field. Please enter valid data.
- **New Students: Please submit copy of Baptismal Certificate.
  
  **Students Receiving Sacraments This Year (First Communion or Confirmation): PLEASE CONFIRM that I already have your Baptismal Certificate, or email/deliver a Copy to me or the Front Office.
- Are there any accommodations we need to take into consideration for this student to excel in a group/educational setting that would help the staff meet their needs? (medical needs, learning or physical needs, mental health needs, etc) REQUIRED Please fill out this field.
- Medical Condition Information
  
  Archdiocesean personnel will take reasonable care to see that the following information will be held in confidence
- Student has/had any of the following medical conditions: check any that apply REQUIRED Siezures Asthma Diabetic Food allergies Depression Anxiety Autism Spectrum ADD/ADHD Has an IEP in school Has a behavior plan in school Had surgery in the last six months Still under a doctor's care for recent surgery Has a medically prescribed diet Has physical limitations none Please fill out this field.
Student 7
- Student's Name REQUIRED Please fill out this field. Please enter valid data.
- I would like to register this student for Faith Formation/Youth Ministry for the following grade: REQUIRED Please fill out this field.
- Gender REQUIRED Male Female Please fill out this field.
- Date of Birth REQUIRED Please fill out this field. Please enter valid data.
- Grade in school REQUIRED Please fill out this field.
- Name of School REQUIRED Please fill out this field. Please enter valid data.
- Student's e-mail (required for students in 6th grade and older) Write "elem" for elementary students. REQUIRED Please fill out this field. Please enter valid data.
- Student's cell (required for 6th grade students and older) Write "ELEM" for elementary students. REQUIRED Please fill out this field. Please enter valid data.
- Are texts okay for 6th Grade students and older? Yes No
- Did student attend Faith Formation/Youth Ministry last year? (this is especially important during Sacramental Formation which requires two years) REQUIRED Yes No Please fill out this field.
- Location of Faith Formation/Youth Ministry last year? REQUIRED Holy Rosary Holy Rosary Catholic School Catholic High School Home Schooled - please show proof of Curriculum or Work Completed Other Please fill out this field.
- Name of School or Church IF NOT Holy Rosary Please enter valid data.
- Student has received the following Sacraments: REQUIRED Baptism Reconciliation Communion Confirmation none Please fill out this field.
- Church of BAPTISM REQUIRED Please fill out this field. Please enter valid data.
- **New Students: Please submit copy of Baptismal Certificate.
  
  **Students Receiving Sacraments This Year (First Communion or Confirmation): PLEASE CONFIRM that I already have your Baptismal Certificate, or email/deliver a Copy to me or the Front Office.
- Are there any accommodations we need to take into consideration for this student to excel in a group/educational setting that would help the staff meet their needs? (medical needs, learning or physical needs, mental health needs, etc) REQUIRED Please fill out this field.
- Medical Condition Information
  
  Archdiocesean personnel will take reasonable care to see that the following information will be held in confidence
- Student has/had any of the following medical conditions: check any that apply REQUIRED Siezures Asthma Diabetic Food allergies Depression Anxiety Autism Spectrum ADD/ADHD Has an IEP in school Has a behavior plan in school Had surgery in the last six months Still under a doctor's care for recent surgery Has a medically prescribed diet Has physical limitations none Please fill out this field.
Student 8
- Student's Name REQUIRED Please fill out this field. Please enter valid data.
- I would like to register this student for Faith Formation/Youth Ministry for the following grade: REQUIRED Please fill out this field.
- Gender REQUIRED Male Female Please fill out this field.
- Date of Birth REQUIRED Please fill out this field. Please enter valid data.
- Grade in school REQUIRED Please fill out this field.
- Name of School REQUIRED Please fill out this field. Please enter valid data.
- Student's e-mail (required for students in 6th grade and older) Write "elem" for elementary students. REQUIRED Please fill out this field. Please enter valid data.
- Student's cell (required for 6th grade students and older) Write "ELEM" for elementary students. REQUIRED Please fill out this field. Please enter valid data.
- Are texts okay for 6th Grade students and older? Yes No
- Did student attend Faith Formation/Youth Ministry last year? (this is especially important during Sacramental Formation which requires two years) REQUIRED Yes No Please fill out this field.
- Location of Faith Formation/Youth Ministry last year? REQUIRED Holy Rosary Holy Rosary Catholic School Catholic High School Home Schooled - please show proof of Curriculum or Work Completed Other Please fill out this field.
- Name of School or Church IF NOT Holy Rosary Please enter valid data.
- Student has received the following Sacraments: REQUIRED Baptism Reconciliation Communion Confirmation none Please fill out this field.
- Church of BAPTISM REQUIRED Please fill out this field. Please enter valid data.
- **New Students: Please submit copy of Baptismal Certificate.
  
  **Students Receiving Sacraments This Year (First Communion or Confirmation): PLEASE CONFIRM that I already have your Baptismal Certificate, or email/deliver a Copy to me or the Front Office.
- Are there any accommodations we need to take into consideration for this student to excel in a group/educational setting that would help the staff meet their needs? (medical needs, learning or physical needs, mental health needs, etc) REQUIRED Please fill out this field.
- Medical Condition Information
  
  Archdiocesean personnel will take reasonable care to see that the following information will be held in confidence
- Student has/had any of the following medical conditions: check any that apply REQUIRED Siezures Asthma Diabetic Food allergies Depression Anxiety Autism Spectrum ADD/ADHD Has an IEP in school Has a behavior plan in school Had surgery in the last six months Still under a doctor's care for recent surgery Has a medically prescribed diet Has physical limitations none Please fill out this field.
Student 9
- Student's Name REQUIRED Please fill out this field. Please enter valid data.
- I would like to register this student for Faith Formation/Youth Ministry for the following grade: REQUIRED Please fill out this field.
- Gender REQUIRED Male Female Please fill out this field.
- Date of Birth REQUIRED Please fill out this field. Please enter valid data.
- Grade in school REQUIRED Please fill out this field.
- Name of School REQUIRED Please fill out this field. Please enter valid data.
- Student's e-mail (required for students in 6th grade and older) Write "elem" for elementary students. REQUIRED Please fill out this field. Please enter valid data.
- Student's cell (required for 6th grade students and older) Write "ELEM" for elementary students. REQUIRED Please fill out this field. Please enter valid data.
- Are texts okay for 6th Grade students and older? Yes No
- Did student attend Faith Formation/Youth Ministry last year? (this is especially important during Sacramental Formation which requires two years) REQUIRED Yes No Please fill out this field.
- Location of Faith Formation/Youth Ministry last year? REQUIRED Holy Rosary Holy Rosary Catholic School Catholic High School Home Schooled - please show proof of Curriculum or Work Completed Other Please fill out this field.
- Name of School or Church IF NOT Holy Rosary Please enter valid data.
- Student has received the following Sacraments: REQUIRED Baptism Reconciliation Communion Confirmation none Please fill out this field.
- Church of BAPTISM REQUIRED Please fill out this field. Please enter valid data.
- **New Students: Please submit copy of Baptismal Certificate.
  
  **Students Receiving Sacraments This Year (First Communion or Confirmation): PLEASE CONFIRM that I already have your Baptismal Certificate, or email/deliver a Copy to me or the Front Office.
- Are there any accommodations we need to take into consideration for this student to excel in a group/educational setting that would help the staff meet their needs? (medical needs, learning or physical needs, mental health needs, etc) REQUIRED Please fill out this field.
- Medical Condition Information
  
  Archdiocesean personnel will take reasonable care to see that the following information will be held in confidence
- Student has/had any of the following medical conditions: check any that apply REQUIRED Siezures Asthma Diabetic Food allergies Depression Anxiety Autism Spectrum ADD/ADHD Has an IEP in school Has a behavior plan in school Had surgery in the last six months Still under a doctor's care for recent surgery Has a medically prescribed diet Has physical limitations none Please fill out this field.
Student 10
- Student's Name REQUIRED Please fill out this field. Please enter valid data.
- I would like to register this student for Faith Formation/Youth Ministry for the following grade: REQUIRED Please fill out this field.
- Gender REQUIRED Male Female Please fill out this field.
- Date of Birth REQUIRED Please fill out this field. Please enter valid data.
- Grade in school REQUIRED Please fill out this field.
- Name of School REQUIRED Please fill out this field. Please enter valid data.
- Student's e-mail (required for students in 6th grade and older) Write "elem" for elementary students. REQUIRED Please fill out this field. Please enter valid data.
- Student's cell (required for 6th grade students and older) Write "ELEM" for elementary students. REQUIRED Please fill out this field. Please enter valid data.
- Are texts okay for 6th Grade students and older? Yes No
- Did student attend Faith Formation/Youth Ministry last year? (this is especially important during Sacramental Formation which requires two years) REQUIRED Yes No Please fill out this field.
- Location of Faith Formation/Youth Ministry last year? REQUIRED Holy Rosary Holy Rosary Catholic School Catholic High School Home Schooled - please show proof of Curriculum or Work Completed Other Please fill out this field.
- Name of School or Church IF NOT Holy Rosary Please enter valid data.
- Student has received the following Sacraments: REQUIRED Baptism Reconciliation Communion Confirmation none Please fill out this field.
- Church of BAPTISM REQUIRED Please fill out this field. Please enter valid data.
- **New Students: Please submit copy of Baptismal Certificate.
  
  **Students Receiving Sacraments This Year (First Communion or Confirmation): PLEASE CONFIRM that I already have your Baptismal Certificate, or email/deliver a Copy to me or the Front Office.
- Are there any accommodations we need to take into consideration for this student to excel in a group/educational setting that would help the staff meet their needs? (medical needs, learning or physical needs, mental health needs, etc) REQUIRED Please fill out this field.
- Medical Condition Information
  
  Archdiocesean personnel will take reasonable care to see that the following information will be held in confidence
- Student has/had any of the following medical conditions: check any that apply REQUIRED Siezures Asthma Diabetic Food allergies Depression Anxiety Autism Spectrum ADD/ADHD Has an IEP in school Has a behavior plan in school Had surgery in the last six months Still under a doctor's care for recent surgery Has a medically prescribed diet Has physical limitations none Please fill out this field.

Insurance Information No, I do not carry medical insurance at this time.

Insurance Carrier Please enter valid data.

Name of Insured Please enter valid data.

Insurance Policy Number: Please enter valid data.

CONSENT & LIABILITY WAIVER

By registering your child(ren) for faith formation you give permission to the parish to provide its catechists with access to your child(ren) for the purpose of catechesis. Depending on the circumstances and the program, this access may be face-to-face in a parish facility, or may be on a virtual platform approved and overseen by the parish, or both. All catechists have been cleared by the Archdiocesan Office of Child and Youth Protection to work with minors and have completed all required safe environment training.

I grant permission for my child/children to participate in Faith Formation and Youth Ministry events to be held during the 2020-2021 academic school year at Holy Rosary Catholic Church, 1416 George Street, Rosenberg, TX 77471.

In consideration of my child's participation in this event, I agree on behalf of myself, my child named herein, and our heirs, successors, and assigns to indemnify, hold harmless and defend the Archdiocese of Galveston-Houston, the sponsoring parish, its pastor, youth ministry leader, principal, other agents, employees or other representatives associated with the event from any and all injuries, losses or claims arising out of my child's participation in the event(s).

Type name of parent signifying "I agree" REQUIRED Please fill out this field. Please enter valid data.

YOUTH PARTICIPANT: In signing the line below, I agree to abide by any/all policies and rules established for this event/activity. Should I not be able to maintain the guidelines and expectations of the adults and my peers, I understand that there will be consequences for my actions, including being removed from the activity and being sent home at my parent's expense.

Type name of youth (6th grade +) signifying "I agree" REQUIRED Please fill out this field. Please enter valid data.

VIDEO/PHOTOGRAPHY CONSENT

By clicking "I agree" below, I understand that promotional pictures and videos (individual and group) will be taken during this event. I give permission for my son's/daughter's picture to be used for promotional materials (newsletter, web page, calendars, power point, video etc.) in highlighting the event.

I agree REQUIRED Yes No Please fill out this field.

MEDICAL CONSENT

In the event it comes to the attention of the chaperones associates with the activity that my child becomes ill with repeated symptoms such as headache, vomiting, sore throat, fever, diarrhea, I want to be called immediately. If this will be a long distance call, I want to be called collect (with phone charges reversed to myself). I fully understand the foregoing statements and sign this Parental/Guardian Medical Consent Waiver knowingly, freely, and willingly.

In typing my name, I certify that all information contained herein is true and accurate to the best of my knowledge.

Type name of parent signifying "I agree" REQUIRED Please fill out this field. Please enter valid data.

Fees

**No child will be denied a religious education because of financial need. We are willing to work with anyone in need of a payment plan or financial assistance.

Registration Fees (Not required for students who attend Holy Rosary Catholic School)
1 child - $85 +$40 after October 30
2 children - $110 +$40 after October 30
3+ children - $135 +$40 after October 30

Sacrament Preparation Fees: (These are still required for students in Catholic Schools)
Reconciliation & First Communion - $65 (includes half day Retreat Fee)
Confirmation (YEAR 2 ONLY/if they are being confirmed THIS SCHOOL YEAR) - $35

Retreat Fees:
Confirmation 1 Retreat $95 Fee (On Campus - One Full Day with Mass Required)
Confirmation 2 Retreat $175 Fee (Off Campus - Full Weekend)
(retreat fees can be paid now or later on in the year)

All fees are payable through Online with Credit or Debit.
If you prefer to pay by cash or check, please let us know.

The Online Payment Link will be sent directly to your email
in your CONFIRMATION EMAIL
once you Submit This Form.
If you do not receive a Confirmation email,
please come back to this page and click "Submit".

HOLY ROSARY CATHOLIC PARISH

HOLY ROSARY CATHOLIC CHURCH & SCHOOL
ST. WENCESLAUS CATHOLIC CHURCH

2022-2023 Registration

Fees