Registration Form

Teen Information

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.
Teen Email REQUIRED Please fill out this field. Please enter valid data.
Primary Parent Email REQUIRED Please fill out this field. Please enter an email address.

Mother's Information

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.
Mother Cell REQUIRED Please fill out this field. Please enter valid data.
Mother Email REQUIRED Please fill out this field. Please enter valid data.

Father's Information

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.
Father Cell REQUIRED Please fill out this field. Please enter valid data.
Father Email REQUIRED Please fill out this field. Please enter valid data.

School REQUIRED Please fill out this field. Please enter valid data.

Grade (2020/2021 School Year) REQUIRED Please fill out this field.

School Type REQUIRED 150 – Public/Private School 0 – Catholic School (No Payment Necessary) Please fill out this field.

I have read and agree to the Diocesan Publish Agreement: REQUIRED Yes Please fill out this field.

Parent Volunteers - Check all you are interested in Catechist Substitute Traffic Control Sunday Service Trip Help Retreat Help Other

Doctor's Name Please enter valid data.

Doctor's Phone Number Please enter valid data.

Insurance Name Please enter valid data.

Insurance Group Number Please enter valid data.

Medical Consent

In the event of an emergency, I hereby give permission to the staff of Corpus Christi Catholic Church to seek emergency medical transport and/or treatment for my child named above. I will be responsible for all costs incurred. I wish to be advised before further care is given by the hospital or doctor.

I Agree Please select this field.

Consent and Liability Waiver

In the event of any accident or injury, I agree on behalf of myself, my child's other parent if known or living, the child named above or our heirs, successors, and assigns, to hold harmless and defend the Diocese of Paterson, its pastor or any representative of Corpus Christi staff, unless the parties involved were careless and negligent. Effective for all Faith Formation activities at Corpus Christi Church

I Agree Please select this field.

Virtual Learning Statement

By registering your child for Faith Formation you give permission to the parish to provide its catechists with access to your child for the purpose of catechesis. Depending on the circumstances and the program, this access may be face-to-face in a parish facility, or may be on a virtual platform approved and overseen by the parish, or both. All catechists have completed all required safe environment training through VIRTUS to work with minors.

I Agree Please select this field.

Accommodations, Support, Health, or Allergy Concerns? REQUIRED Please fill out this field.

Do you have a way to access Faith Formation Online? REQUIRED Yes Yes, but with limitations No Please fill out this field.

Parent/Guardian Electronic Signature: REQUIRED Please fill out this field. Please enter valid data.