Route20Catholic Family Catechesis and Sacramental Prep Registration Form 2024/2025

If you have any difficulties or trouble registering your Child for Family Catechesis, Sacramental Prep for First Reconciliation/First Communion, or Sacramental Prep for Confirmation, please reach out to Ms. Stacey at the information below.

Email: Smiller@syrdio.org
Phone: (315) 841-4481 option 6

Please complete a registration form, for your child even if they participated in a previous year of faith formation with Route20Catholic, so that we will have accurate information should anything arise.

Route20Catholic Family Catechesis/Sacramental Prep Contact Information:

Primary Parent Information:

Full Name of Parent/Guardian:

Phone number where you can be reached:

Email address:

This address will receive a confirmation email

Home Address:

Mailing Address (if different):

Relationship to Child being registered:

Mother Father Grandparent Legal Guardian/Other

Home Parish: (please choose the one you attend most frequently)

St. Bernard's Waterville St. Mary's Hamilton St. Joseph's Oriskany Falls St. Joan of Arc Morrisville

Secondary Parent Information:

Full Name of Parent/Guardian:

Phone number where you can be reached:

Email:

This address will receive a confirmation email

Home Address (if different from above):

Relationship to Child being registered: Mother Father Grandparent Legal Guardian/Other

Home Parish: (please choose the one you attend most frequently) St. Bernard's Waterville St. Mary's Hamilton St. Joseph's Oriskany Falls St. Joan of Arc Morrisville

Information regarding the Child being registered:

Please complete a seprate registration form for each child participating in any of the programs offered at Route20Catholic. (Family Catechesis, Sacramental Prep: First Reconciliation/First Communion, Sacramental Prep: Confirmation)

Also please register your child even if they participated in a previous year, so that we can have accurate numbers of children enrolled and any updtated information, should an issue arise.

Child's Full Name:

Child's Date of Birth:

Email Address of Student: (We will include grades 7-10 in emails to make them aware of classes and upcoming changes to scheduling as well as parents)

Home Parish: (please choose the one your family attends most frequently)

St. Bernard's Waterville St. Mary's Hamilton St. Joseph's Oriskany Falls St Joan of Arc Morrisville

Grade Level for the 2024/2025 year:

Church of Baptism:

City & State of Baptism:

Date of Baptism:

Please include if the child has any special needs, medical needs (including allergies), learning needs, or other information:

The information shared on this form will be kept confidential and will only be shared with the Catechetical Leaders, Pastor, your Child's Catechists (teacher), and in the case of a medical emergency, as appropriate.

Registration Fee: (Payment information below)

We have changed up the Registration Fee this year, for Family Catechesis Grades 1-6, and First Sacraments it is $15 per student. Which will cover the cost of the materials we will be using with our new program. However, there is a different cost for students in Grades 7-10 & Confirmation 2, of $25, this year, as we are also using a new program for both groups as well. If you have children in both programs you will pay for both the Grade 1-6 fee and the Grade 7-10 & Confirmation 2 Fee. Regardless of which program(s) you are enrolling your child/children in the maximum cost to your family will be $40. If you have any concerns over the cost, please reach out to either Ms. Stacey or Fr. Donovan. If you do not wish to pay online you may turn in a check made out to your home parish on the first day of classes to your student's teacher, or Ms. Stacey. Please include Faith Formation Registration in the Memo line so the funds can be earmarked to cover the costs of our program.

Online Instruction:

In the event that online instruction is deemed necessary, two Catechsist will be present, during instruction.

My Child has my permission to participate in online Catechesis within the Route20Catholic PCA. I understand that a subsequent email will be forwarded providing the dates and times of the sessions.

Yes No

Onsite instruction:

Whom should we contact if Primary or Seconday Parent/Guardian cannot be reached in the event of an Emergency?

Full Name:

Phone Number for Contact:

Relationship to Student:

If there is anyone we CANNOT or you DO NOT want to have your child released to please provide the information below:

Full Name:

Relationship to Child:

Please include any additional information we should have:

Releases: (Photo, Emergency, Pick-up)

I (we) the parent(s) and/or guardian of the child listed above, do hereby consent and authorize the release, publication, dissemination, distrubution, use and/or reporduction of any and all photographs taken of said child during enrollment in Route20Catholic and may be used by all the churches within this PCA for any purpose determined at their discretion, without further notice or any compensation to me (us) or the child.

If you do not want to have your child's photo please type: I do not wish to have my child's photo taken.

Photo Consent: Please type Parent's Full Name, giving consent:

In the event of a medical emergency, I understand that every effort will be made to contact the parents/guardian. In the event that I cannot be reached I hereby give premission to secure proper treatment for my child named herein.

By typing your name below, you give consent (this is required for participation):

Please select the appropriate statement:

I will pick up my child after instruction. My child has permission to leave with the following individual(s):

Full Name of approved individual for pick up:

Programs of interest:

What Catechetical programs are you interested in:

Family Catechesis (Grades 1-8th) Sacramental prep for First Reconciliation/First Communion prep (grade 2) Sacramental prep for Confirmation RCIA Other

Questions/Comments:

If you have any further questions or comments, please leave them here. Ms. Stacey will respond to them as timely as possible. If you do not hear back from her in a few days please reach out to her directly at smiller@syrdio.org or call the Parish office directly at (315) 841-4481, choose option 6, for her voicemail. We look forward to a new and exciting year, thank you for registering your child(ren) with Route20Catholic.

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Route20Catholic Family Catechesis and Sacramental Prep Registration Form 2024/2025

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