Faith Formation Online Registration

Are You Registering for a Sacramental year?: Grade 2 receives Reconciliation and First Communion. Grade 8 receives Confirmation.

Mother's First and Last Name REQUIRED Please fill out this field. Please enter valid data.

Father's First and Last Name REQUIRED Please fill out this field. Please enter valid data.

Street 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.

Catholic? Yes No

Family registered at Santa Maria del Mar? REQUIRED Yes No Please fill out this field.

Mother's E-mail REQUIRED Please fill out this field. Please enter valid data.

Father's E-mail REQUIRED Please fill out this field. Please enter valid data.

Mother's Maiden Name (Needed for Sacramental Records) REQUIRED Please fill out this field. Please enter valid data.

Is Mother Catholic? REQUIRED Yes No Please fill out this field.

Is Father Catholic? REQUIRED Yes No Please fill out this field.

Number of Children to Be Registered REQUIRED Please fill out this field.
Child 1
- Student's Last Name REQUIRED Please fill out this field. Please enter valid data.
- Student's First Name REQUIRED Please fill out this field. Please enter valid data.
- Student's Middle Name Please enter valid data.
- Student's Date of Birth REQUIRED Please fill out this field. Please enter valid data.
- Current Grade REQUIRED Please fill out this field. Please enter valid data.
- Sacramental Year? REQUIRED 40.0 – Yes 0.0 – No Please fill out this field.
- LifeTeen Donation (not required)
  Donation is not required but it is helpful to offest costs to run program
  $ Please enter a positive decimal.
- Please provide any special educational or physical needs or any food allergies: Please enter valid data.
- Current School REQUIRED Please fill out this field. Please enter valid data.
- Is the Student Baptized Catholic? REQUIRED Yes No Please fill out this field.
- Date of Baptism REQUIRED Please fill out this field. Please enter valid data.
- Church of Baptism REQUIRED Please fill out this field. Please enter valid data.
- Child Sacraments Received Communion Confirmation
Child 2
- Student's Last Name REQUIRED Please fill out this field. Please enter valid data.
- Student's First Name REQUIRED Please fill out this field. Please enter valid data.
- Student's Middle Name Please enter valid data.
- Student's Date of Birth REQUIRED Please fill out this field. Please enter valid data.
- Current Grade REQUIRED Please fill out this field. Please enter valid data.
- Sacramental Year? REQUIRED 40.0 – Yes 0.0 – No Please fill out this field.
- LifeTeen Donation (not required)
  Donation is not required but it is helpful to offest costs to run program
  $ Please enter a positive decimal.
- Please provide any special educational or physical needs or any food allergies: Please enter valid data.
- Current School REQUIRED Please fill out this field. Please enter valid data.
- Is the Student Baptized Catholic? REQUIRED Yes No Please fill out this field.
- Date of Baptism REQUIRED Please fill out this field. Please enter valid data.
- Church of Baptism REQUIRED Please fill out this field. Please enter valid data.
- Child Sacraments Received Communion Confirmation
Child 3
- Student's Last Name REQUIRED Please fill out this field. Please enter valid data.
- Student's First Name REQUIRED Please fill out this field. Please enter valid data.
- Student's Middle Name Please enter valid data.
- Student's Date of Birth REQUIRED Please fill out this field. Please enter valid data.
- Current Grade REQUIRED Please fill out this field. Please enter valid data.
- Sacramental Year? REQUIRED 40.0 – Yes 0.0 – No Please fill out this field.
- LifeTeen Donation (not required)
  Donation is not required but it is helpful to offest costs to run program
  $ Please enter a positive decimal.
- Please provide any special educational or physical needs or any food allergies: Please enter valid data.
- Current School REQUIRED Please fill out this field. Please enter valid data.
- Is the Student Baptized Catholic? REQUIRED Yes No Please fill out this field.
- Date of Baptism REQUIRED Please fill out this field. Please enter valid data.
- Church of Baptism REQUIRED Please fill out this field. Please enter valid data.
- Child Sacraments Received Communion Confirmation
Child 4
- Student's Last Name REQUIRED Please fill out this field. Please enter valid data.
- Student's First Name REQUIRED Please fill out this field. Please enter valid data.
- Student's Middle Name Please enter valid data.
- Student's Date of Birth REQUIRED Please fill out this field. Please enter valid data.
- Current Grade REQUIRED Please fill out this field. Please enter valid data.
- Sacramental Year? REQUIRED 40.0 – Yes 0.0 – No Please fill out this field.
- LifeTeen Donation (not required)
  Donation is not required but it is helpful to offest costs to run program
  $ Please enter a positive decimal.
- Please provide any special educational or physical needs or any food allergies: Please enter valid data.
- Current School REQUIRED Please fill out this field. Please enter valid data.
- Is the Student Baptized Catholic? REQUIRED Yes No Please fill out this field.
- Date of Baptism REQUIRED Please fill out this field. Please enter valid data.
- Church of Baptism REQUIRED Please fill out this field. Please enter valid data.
- Child Sacraments Received Communion Confirmation
Child 5
- Student's Last Name REQUIRED Please fill out this field. Please enter valid data.
- Student's First Name REQUIRED Please fill out this field. Please enter valid data.
- Student's Middle Name Please enter valid data.
- Student's Date of Birth REQUIRED Please fill out this field. Please enter valid data.
- Current Grade REQUIRED Please fill out this field. Please enter valid data.
- Sacramental Year? REQUIRED 40.0 – Yes 0.0 – No Please fill out this field.
- LifeTeen Donation (not required)
  Donation is not required but it is helpful to offest costs to run program
  $ Please enter a positive decimal.
- Please provide any special educational or physical needs or any food allergies: Please enter valid data.
- Current School REQUIRED Please fill out this field. Please enter valid data.
- Is the Student Baptized Catholic? REQUIRED Yes No Please fill out this field.
- Date of Baptism REQUIRED Please fill out this field. Please enter valid data.
- Church of Baptism REQUIRED Please fill out this field. Please enter valid data.
- Child Sacraments Received Communion Confirmation
Child 6
- Student's Last Name REQUIRED Please fill out this field. Please enter valid data.
- Student's First Name REQUIRED Please fill out this field. Please enter valid data.
- Student's Middle Name Please enter valid data.
- Student's Date of Birth REQUIRED Please fill out this field. Please enter valid data.
- Current Grade REQUIRED Please fill out this field. Please enter valid data.
- Sacramental Year? REQUIRED 40.0 – Yes 0.0 – No Please fill out this field.
- LifeTeen Donation (not required)
  Donation is not required but it is helpful to offest costs to run program
  $ Please enter a positive decimal.
- Please provide any special educational or physical needs or any food allergies: Please enter valid data.
- Current School REQUIRED Please fill out this field. Please enter valid data.
- Is the Student Baptized Catholic? REQUIRED Yes No Please fill out this field.
- Date of Baptism REQUIRED Please fill out this field. Please enter valid data.
- Church of Baptism REQUIRED Please fill out this field. Please enter valid data.
- Child Sacraments Received Communion Confirmation

Emergency Contacts during class (Name and cell number) REQUIRED Please fill out this field. Please enter valid data.

A copy of your Child(ren) certificates must be submitted if not on file. You can submit certificates by:

- Submitting via e-mail to Ms. Margie at Margie@smdmcc.org
- Mailing or dropping off at the church office to the attention of Ms. Margie

Child Photo Release:Child Photography Release Pursuant to law, and with respect for family privacy and safety concerns, Santa Maria del Mar Catholic Church in Flagler Beach, Florida will not release any photograph without prior written consent from you as parent or guardian.

(Please Check one) permission for a photo/image that includes our child without any other personal identifiers (no name, no age, no address, just as a member of this church) to be published on the church’s or diocese’s public Internet site, in publications of the church or diocese, and/or in other media that may publicize church events.

Permission I GRANT permission for my child(ren) to be photographed I DO NOT GRANT permission for my child(ren) to be photographed

Payment Amount REQUIRED Please fill out this field.