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Children's Faith Formation/YOUTH MINISTRY

(Grades KINDERGARTEN THRU GRADE 12)

- Faith Formation
Contact Us
- Shelly Carpenter
  
  Catechetical Leader
  
  (207) 324-2420

Faith Formation/YOUTH MINISTRY Registration
The maximum number of form submissions has been reached. This form is currently not available.
- If your child(ren) will be receiving sacraments this year and was not baptized at St. Thérèse of Lisieux Parish (Holy Family Church or Notre Dame Church) or the former St. Ignatius Church, Springvale you need to acquire their sealed baptismal certificate when you register.
- Family Last Name REQUIRED Please fill out this field. Please enter valid data.
- Parent/Guardian 1 (with whom the child resides)
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Relationship REQUIRED Please fill out this field.
- Address REQUIRED Please fill out this field. 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.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Primary Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Secondary Phone Number Maximum 20 characters Please enter a phone number.
- Parent/Guardian 2 (if applicable)
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- Relationship
- Address Please enter valid data.
- City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
- Email Please enter an email address.
- Primary Phone Number Maximum 20 characters Please enter a phone number.
- Secondary Phone Number Maximum 20 characters Please enter a phone number.
- Children Registering in Faith Formation REQUIRED Please fill out this field.
  
  Child 1
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Nickname (if applicable) Please enter valid data.
  
  Date of Birth (MM/DD/YY) REQUIRED Please fill out this field. Please enter valid data.
  
  School Attending REQUIRED Please fill out this field. Please enter valid data.
  
  Grade in School (entering in Fall) REQUIRED Please fill out this field. Please enter valid data.
  
  Sacraments Already Received Baptism First Communion First Reconciliation/Confession Confirmation
  
  Has your child attended a religious education program elsewhere? REQUIRED Please fill out this field.
  
  If so, where? Please enter valid data.
  
  Medical Information
  (This information will be kept confidential and only shared with those who need to know.)
  
  Allergies (medication, food, etc.) REQUIRED Yes No Please fill out this field.
  
  If so, please list allergies: Please enter valid data.
  
  You should be aware of the following disabilities or medical conditions of my child (if applicable): Please enter valid data.
  
  If applicable, my child regularly takes the following medications (indicate dosage and frequency): Please enter valid data.
  
  Physician Name REQUIRED Please fill out this field. Please enter valid data.
  
  Physician Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Insurance Carrier REQUIRED Please fill out this field. Please enter valid data.
  
  Insurance Policy Number REQUIRED Please fill out this field. Please enter valid data.
  
  Insurance Policy Holder Name REQUIRED Please fill out this field. Please enter valid data.
  
  Child 2
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Nickname (if applicable) Please enter valid data.
  
  Date of Birth (MM/DD/YY) REQUIRED Please fill out this field. Please enter valid data.
  
  School Attending REQUIRED Please fill out this field. Please enter valid data.
  
  Grade in School (entering in Fall) REQUIRED Please fill out this field. Please enter valid data.
  
  Sacraments Already Received Baptism First Communion First Reconciliation/Confession Confirmation
  
  Has your child attended a religious education program elsewhere? REQUIRED Please fill out this field.
  
  If so, where? Please enter valid data.
  
  Medical Information
  (This information will be kept confidential and only shared with those who need to know.)
  
  Allergies (medication, food, etc.) REQUIRED Yes No Please fill out this field.
  
  If so, please list allergies: Please enter valid data.
  
  You should be aware of the following disabilities or medical conditions of my child (if applicable): Please enter valid data.
  
  If applicable, my child regularly takes the following medications (indicate dosage and frequency): Please enter valid data.
  
  Physician Name REQUIRED Please fill out this field. Please enter valid data.
  
  Physician Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Insurance Carrier REQUIRED Please fill out this field. Please enter valid data.
  
  Insurance Policy Number REQUIRED Please fill out this field. Please enter valid data.
  
  Insurance Policy Holder Name REQUIRED Please fill out this field. Please enter valid data.
  
  Child 3
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Nickname (if applicable) Please enter valid data.
  
  Date of Birth (MM/DD/YY) REQUIRED Please fill out this field. Please enter valid data.
  
  School Attending REQUIRED Please fill out this field. Please enter valid data.
  
  Grade in School (entering in Fall) REQUIRED Please fill out this field. Please enter valid data.
  
  Sacraments Already Received Baptism First Communion First Reconciliation/Confession Confirmation
  
  Has your child attended a religious education program elsewhere? REQUIRED Please fill out this field.
  
  If so, where? Please enter valid data.
  
  Medical Information
  (This information will be kept confidential and only shared with those who need to know.)
  
  Allergies (medication, food, etc.) REQUIRED Yes No Please fill out this field.
  
  If so, please list allergies: Please enter valid data.
  
  You should be aware of the following disabilities or medical conditions of my child (if applicable): Please enter valid data.
  
  If applicable, my child regularly takes the following medications (indicate dosage and frequency): Please enter valid data.
  
  Physician Name REQUIRED Please fill out this field. Please enter valid data.
  
  Physician Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Insurance Carrier REQUIRED Please fill out this field. Please enter valid data.
  
  Insurance Policy Number REQUIRED Please fill out this field. Please enter valid data.
  
  Insurance Policy Holder Name REQUIRED Please fill out this field. Please enter valid data.
  
  Child 4
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Nickname (if applicable) Please enter valid data.
  
  Date of Birth (MM/DD/YY) REQUIRED Please fill out this field. Please enter valid data.
  
  School Attending REQUIRED Please fill out this field. Please enter valid data.
  
  Grade in School (entering in Fall) REQUIRED Please fill out this field. Please enter valid data.
  
  Sacraments Already Received Baptism First Communion First Reconciliation/Confession Confirmation
  
  Has your child attended a religious education program elsewhere? REQUIRED Please fill out this field.
  
  If so, where? Please enter valid data.
  
  Medical Information
  (This information will be kept confidential and only shared with those who need to know.)
  
  Allergies (medication, food, etc.) REQUIRED Yes No Please fill out this field.
  
  If so, please list allergies: Please enter valid data.
  
  You should be aware of the following disabilities or medical conditions of my child (if applicable): Please enter valid data.
  
  If applicable, my child regularly takes the following medications (indicate dosage and frequency): Please enter valid data.
  
  Physician Name REQUIRED Please fill out this field. Please enter valid data.
  
  Physician Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Insurance Carrier REQUIRED Please fill out this field. Please enter valid data.
  
  Insurance Policy Number REQUIRED Please fill out this field. Please enter valid data.
  
  Insurance Policy Holder Name REQUIRED Please fill out this field. Please enter valid data.
  
  Child 5
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Nickname (if applicable) Please enter valid data.
  
  Date of Birth (MM/DD/YY) REQUIRED Please fill out this field. Please enter valid data.
  
  School Attending REQUIRED Please fill out this field. Please enter valid data.
  
  Grade in School (entering in Fall) REQUIRED Please fill out this field. Please enter valid data.
  
  Sacraments Already Received Baptism First Communion First Reconciliation/Confession Confirmation
  
  Has your child attended a religious education program elsewhere? REQUIRED Please fill out this field.
  
  If so, where? Please enter valid data.
  
  Medical Information
  (This information will be kept confidential and only shared with those who need to know.)
  
  Allergies (medication, food, etc.) REQUIRED Yes No Please fill out this field.
  
  If so, please list allergies: Please enter valid data.
  
  You should be aware of the following disabilities or medical conditions of my child (if applicable): Please enter valid data.
  
  If applicable, my child regularly takes the following medications (indicate dosage and frequency): Please enter valid data.
  
  Physician Name REQUIRED Please fill out this field. Please enter valid data.
  
  Physician Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Insurance Carrier REQUIRED Please fill out this field. Please enter valid data.
  
  Insurance Policy Number REQUIRED Please fill out this field. Please enter valid data.
  
  Insurance Policy Holder Name REQUIRED Please fill out this field. Please enter valid data.
  
  Child 6
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Nickname (if applicable) Please enter valid data.
  
  Date of Birth (MM/DD/YY) REQUIRED Please fill out this field. Please enter valid data.
  
  School Attending REQUIRED Please fill out this field. Please enter valid data.
  
  Grade in School (entering in Fall) REQUIRED Please fill out this field. Please enter valid data.
  
  Sacraments Already Received Baptism First Communion First Reconciliation/Confession Confirmation
  
  Has your child attended a religious education program elsewhere? REQUIRED Please fill out this field.
  
  If so, where? Please enter valid data.
  
  Medical Information
  (This information will be kept confidential and only shared with those who need to know.)
  
  Allergies (medication, food, etc.) REQUIRED Yes No Please fill out this field.
  
  If so, please list allergies: Please enter valid data.
  
  You should be aware of the following disabilities or medical conditions of my child (if applicable): Please enter valid data.
  
  If applicable, my child regularly takes the following medications (indicate dosage and frequency): Please enter valid data.
  
  Physician Name REQUIRED Please fill out this field. Please enter valid data.
  
  Physician Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Insurance Carrier REQUIRED Please fill out this field. Please enter valid data.
  
  Insurance Policy Number REQUIRED Please fill out this field. Please enter valid data.
  
  Insurance Policy Holder Name REQUIRED Please fill out this field. Please enter valid data.
  
  Child 7
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Nickname (if applicable) Please enter valid data.
  
  Date of Birth (MM/DD/YY) REQUIRED Please fill out this field. Please enter valid data.
  
  School Attending REQUIRED Please fill out this field. Please enter valid data.
  
  Grade in School (entering in Fall) REQUIRED Please fill out this field. Please enter valid data.
  
  Sacraments Already Received Baptism First Communion First Reconciliation/Confession Confirmation
  
  Has your child attended a religious education program elsewhere? REQUIRED Please fill out this field.
  
  If so, where? Please enter valid data.
  
  Medical Information
  (This information will be kept confidential and only shared with those who need to know.)
  
  Allergies (medication, food, etc.) REQUIRED Yes No Please fill out this field.
  
  If so, please list allergies: Please enter valid data.
  
  You should be aware of the following disabilities or medical conditions of my child (if applicable): Please enter valid data.
  
  If applicable, my child regularly takes the following medications (indicate dosage and frequency): Please enter valid data.
  
  Physician Name REQUIRED Please fill out this field. Please enter valid data.
  
  Physician Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Insurance Carrier REQUIRED Please fill out this field. Please enter valid data.
  
  Insurance Policy Number REQUIRED Please fill out this field. Please enter valid data.
  
  Insurance Policy Holder Name REQUIRED Please fill out this field. Please enter valid data.
  
  Child 8
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Nickname (if applicable) Please enter valid data.
  
  Date of Birth (MM/DD/YY) REQUIRED Please fill out this field. Please enter valid data.
  
  School Attending REQUIRED Please fill out this field. Please enter valid data.
  
  Grade in School (entering in Fall) REQUIRED Please fill out this field. Please enter valid data.
  
  Sacraments Already Received Baptism First Communion First Reconciliation/Confession Confirmation
  
  Has your child attended a religious education program elsewhere? REQUIRED Please fill out this field.
  
  If so, where? Please enter valid data.
  
  Medical Information
  (This information will be kept confidential and only shared with those who need to know.)
  
  Allergies (medication, food, etc.) REQUIRED Yes No Please fill out this field.
  
  If so, please list allergies: Please enter valid data.
  
  You should be aware of the following disabilities or medical conditions of my child (if applicable): Please enter valid data.
  
  If applicable, my child regularly takes the following medications (indicate dosage and frequency): Please enter valid data.
  
  Physician Name REQUIRED Please fill out this field. Please enter valid data.
  
  Physician Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Insurance Carrier REQUIRED Please fill out this field. Please enter valid data.
  
  Insurance Policy Number REQUIRED Please fill out this field. Please enter valid data.
  
  Insurance Policy Holder Name REQUIRED Please fill out this field. Please enter valid data.
- Emergency Contact Information
  (This information will be kept confidential and only shared with those who need to know.)
- Emergency Contact 1
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Emergency Contact 2
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Notice
  If a sudden illness or other serious medical emergency should occur and I cannot be reached, by submitting this registration, I hereby authorize the person in charge to call my physician or to take my child to the nearest emergency clinic.
- Pick-Up from Faith Formation Programs
  In addition to parents/guardians, the following people may pick up my child. Your child will only be released to these people. They must be 18 years of age or older, and must show a photo ID. Please list name, phone number, and relationship.
- Authorized person/people (name and relationship):
- The following person/people MAY NOT pick up my child(ren) (name and relationship):
- Registration Fee
  A registration fee of $25.00 per child is due at the time of registration. Please make checks payable to St. Thérèse of Lisieux Parish. It is assumed that families are attending weekly Mass and are making weekly donations to the offertory collection. Parish funds greatly supplement Faith Formation programs.
  
  Sacramental Records
  If your child(ren) will be receiving sacraments this year and was not baptized at St. Thérèse of Lisieux Parish (Holy Family Church (Sanford), Notre Dame Church (Springvale), or the former St. Ignatius Church (Sanford)), you will need to provide their official baptismal certificate when you register.
  
  Photograph Release
  Photographs are sometimes taken during faith formation sessions and events. They are displayed publicly (e.g., on the parish website, in the newspaper, in a brochure, on bulletin boards, Facebook, etc.) and used to keep the community aware and informed of parish events and activities. Names will not be posted. By submitting this registration, you grant permission for photographs to be taken and used. If you do not want images taken and used as described, please send a written notice to that effect to the Parish Catechetical Leader.
- Digital Signature
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Date REQUIRED Please fill out this field. Please enter a date.
Submit

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Documents
- Faith Formation/Youth Ministry Registration Form (3 pages)

Saint Thérèse of Lisieux Parish

Sanford-Springvale

Children's Faith Formation/YOUTH MINISTRY

(Grades KINDERGARTEN THRU GRADE 12)

Contact Us

Faith Formation/YOUTH MINISTRY Registration

Documents

Children's Faith Formation/YOUTH MINISTRY (Grades KINDERGARTEN THRU GRADE 12)

Children's Faith Formation/YOUTH MINISTRY

(Grades KINDERGARTEN THRU GRADE 12)