Faith Formation Registration Classes begin Sunday Sept 12th at 9:15 following Mass 2021-22 Family Formation Registration All parents of Children of the parish ages 2-18 If not registered in the parish please see that form. Name* First Last 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 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.I would like to register my family for family formation.YesNoMy family's preference for the monthly gathering would be? (Mark all that apply) Sunday Morning Sunday Afternoon Sunday Evening Monday Evening Tuesday Evening Wednesday Evening Thursday Evening Friday Evening Saturday Morning Saturday Afternoon Saturday Evening I would prefer to meet each month during the First Week Second Week Third Week Fourth Week Any My family's preferred language English Spanish My family has access to online materials. Yes No My family is able to print monthly activities and resources. Yes No My family is comfortable attending in-person gatherings within the Dioceses safety guidelines. 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 school student interested in the following... Sunday Night Prayer - Keeping It Holy Monday Night Prayer - Saints for Inspiration Wednesday Night Discovery - Catholic Social Teaching Name of Child* First Name Grade First Name Grade First Name Grade First Name Grade First Name Grade First Name Grade
