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Saint Thérèse of Lisieux Parish
Sanford-Springvale
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FORMED
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Children's Faith Formation/YOUTH MINISTRY
(Grades KINDERGARTEN THRU GRADE 12)
Faith Formation
Children's Faith Formation
Youth Ministry (Grades 6-12)
Adult Faith Formation
Becoming Catholic
FORMED
Vacation Bible School
Faith Formation Registration
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
(Select One)
Father
Mother
Stepparent
Grandparent
Other
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
AK
AL
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AZ
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CO
CT
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DE
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GU
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KY
LA
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UT
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VI
VT
WA
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WV
WY
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
None
Father
Mother
Stepparent
Grandparent
Other
Address
Please enter valid data.
City
Please enter valid data.
State
None
AK
AL
AR
AS
AZ
CA
CO
CT
DC
DE
FL
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MH
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
PW
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
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
(Select One)
Yes
No
Not sure
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
(Select One)
Yes
No
Not sure
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
(Select One)
Yes
No
Not sure
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
(Select One)
Yes
No
Not sure
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
(Select One)
Yes
No
Not sure
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
(Select One)
Yes
No
Not sure
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
(Select One)
Yes
No
Not sure
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
(Select One)
Yes
No
Not sure
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)