St. John The Beloved

Catholic Church

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First Eucharist/Reconciliation Form

- Faith Formation

FIRST RECONCILIATON/EUCHARIST REGISTRATION FORM for 2021-2022
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- Are you a register member of St. John the Beloved REQUIRED Please fill out this field.
- Child's Name Please enter valid data.
- Address Please enter valid data.
- City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
- Age Please enter valid data.
- Grade (2021-22) Please enter valid data.
- Child's Current School Please enter valid data.
- Birthdate Please enter valid data.
- Church of Baptism Please enter valid data.
- City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
- NOTE: If your child was NOT Baptized at St. John the Beloved, please be sure to get a copy of your child's Baptismal Certificate to Parish Office ASAP. Thank you.
- Parent #1 Name Please enter valid data.
- Parent #1 Phone Please enter valid data.
- Parent #1 Email Please enter valid data.
- Parent #2 Name Please enter valid data.
- Parent #2 Phone Please enter valid data.
- Parent #2 Email Please enter valid data.
- MODEL RELEASE STATEMENT
  
  I hereby grant permission for my child/children to be photographed and/or videotaped during ministry activities and events. I understand that my child/children may decline to be photographed and/or videotaped at any time. I further grant permission for the resulting photographs and/or videotaped footage to be edited, if necessary, and published and/or broadcast for the purposes of promoting ministry and/or youth programs at St. John the Beloved Roman Catholic Church.
- Permission Granted Yes, I grant permission as stated above. No, my child may not be photographed or videotaped under any circumstances.
- There are FEES associated with preparing or receiving a Sacrament at St. John the Beloved.
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