Battenkill Catholic Lifelong Faith
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Scripture - Breath of God
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Registration - Confirmation Preparation
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Indicates required field
Home Parish
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Holy Cross, Salem
Immaculate Conception, Hoosick Falls
St. Patrick's, Cambridge
Preferred Sessions:
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Sundays, 10 - 11:15 am, St. Patrick's
Wednesdays, 6:30 - 8 pm, Immaculate Conception
Candidate's Name
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First
Last
Date of Birth
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Date and Place of Baptism
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School
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Grade
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Name of Parent or Guardian #1
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First
Last
[object Object]
Name of Parent or Guardian #2
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First
Last
Candidate's Home Address
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Line 1
Line 2
City
State
Zip Code
Country
Parent Email
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Student Email
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Home Phone Number
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Student Phone Number
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Parent/Guardian #1 Cell Phone Number
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Parent/Guardian #2 Cell Phone Number
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Emergency Contact
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First
Last
Phone Number
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Please list any allergies or medical needs.
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Please explain any custody issues that we should know about in order to serve your family.
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Please list any special learning needs or anything else we need to know about the candidate to improve his/her experience in Faith Formation.
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Comment
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Permission to participate in group video calls (Zoom).
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I hereby give my permission for my child to participate in group video calls (Zoom).
Permission for Photographs/Videotapes/Films
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I hereby authorize and give my consent for the taking of pictures (moving or still) of my child and further give my permission for their reproduction for teaching purposes, news release, publication, or community awareness programs.
Is there any other way we can be of assistance to your child or family?
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Date
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Signature
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Submit