Battenkill Catholic Lifelong Faith
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Registration - Preparation for First Reconciliation and First Eucharist
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Please Select Your Parish
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Holy Cross, Salem
Immaculate Conception, Hoosick Falls
St. Patrick's, Cambridge
Student'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
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Name of Parent or Guardian #2
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First
Last
Child'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 your child to improve his/her experience in Faith Formation.
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Comment
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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