2023-24 Faith Formation Registration 2023-24 Family Formation Registration All parents of Children of the parish ages 2-18 If not registered in the parish please see that form. Parents Name* First Last Students Name* First Last Grade Students Name First Last Grade Students Name First Last Grade Students Name First Last Grade Students Name First Last Grade Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Primary Contact Email* Primary Contact Phone*Primary Contact's Preferred method of Contact Email Text Message Secondary Contact Name First Last Secondary Contact Email Secondary Contact PhoneEmergency Contact, not listed above.* First Last Dietary Restrictions / Allergies (please include students name)* Emergency Contact Phone*Consent I authorize any representative of St. Mary’s Church as my agent to consent to any emergency examination, x-ray, anesthetic, medical or surgical diagnosis or treatment and hospital care which is deemed advisable by and is rendered under the supervision of a licensed physician or surgeon. I am aware that all attempts will be made to contact me first in case of an emergency and that this is ONLY if I or my emergency contact cannot be reached.Consent I hereby consent to the use and release of any photograph that my child is in for promotional materials or news stories in St. Mary’s Parish and the Diocese of Davenport. I understand that these photographs may be posted on the parish or diocesan websites as well.My family's preferred language English Spanish My family has access to online materials. Yes No My family is able to print activities and resources. Yes No I would like more information on sacrament preparation. I have a child(ren) grade 7th or older wanting to prepare for Confirmation. I have a child(ren) grade 2nd or older wanting to prepare for Fist Sacraments. I have a high schooler interested in… Sunday morning Bible Study Wednesday afternoon Discipleship Group This year we are requiring parents to help cover the materials for faith formation. $35 for the first two children and the rest are free. If you are unable to pay please contact the Priest or Director of Religious Education. Checks can be made out to St. Mary's and must be turned in before the Memorial Day weekend.* I can pay at this time. I can pay partially at this time. I cannot pay at this time.