Fill out and submit the form below and drop off or mail the check to:
Blessed Sacrament Catholic Church210 5th Ave WestWest Fargo ND 58078
Downloadable Faith Formation Registration Form.
Name
Address
Home Phone
Unlisted Number? Yes No
Cell Phone
As a family we attend 5:15 p.m. 8:30 a.m. 10:30 a.m.
For information sharing purposes, please share with us your current email:
Family Email Address
Dad's Email
Mom's Email
Relationship
Sex
Occupation
Business Phone
Religion
Contact Address
Emergency Phone #
Remarks
Student 1
Grade
School
Birth Date
Class Time
B R C E
Student 2
Student 3
Student 4
Student 5
THE FOLLOWING IS A LEGAL PERMISSION. PLEASE BE SURE TO READ IT BEFORE SIGNING:
In the event I cannot be reached for a medical emergency, I hereby give permisson to the physician selected by the DFF/YM or his/her designee to hospitalize, secure proper treatment for, and to order injection, anesthesia, or surgery for my child(ren) as named above. I give permisson to administer first aid for my child. Limitations:
Signature of Parent/Guardian
Date Signed
Registration Fees $40.00 per Student, up to a maximum of maximum of $110.00.
