Family Faith Formation Registration

Welcome to the Family Faith Formation Registration Page! We welcome you and your family to the many life-changing formation programs offered at Our Lady of Mercy Parish. Please note that this registration page is for ALL our programs for Families with children Grade Kindergarten through Grade 12 (including Sacrament preparation for First Reconciliation, First Eucharist and Confirmation).

Family Faith Formation Registration Form 2023-2024

Family Faith Formation registration form for grades K-12 for the 2023-2024 school year

"*" indicates required fields

Step 1 of 5 – Family Information

Family Information

Please complete this registration form for ALL your children (Grades K-12) who will be in a program this coming year. Please fill out the family information below.

Family Last Name*

Registered OLM Parishioner?*

Yes – Family is a registered parishioner at Our Lady of Mercy

No – Family is not a registered parishioner at Our Lady of Mercy

Email – Primary*

Cell Phone – Primary*

Home Phone

Address*

Street Address Address Line 2 City State ZIP Code

Information – Parent / Guardian

Mother's / Guardian's Name*

First Last

Mother's / Guardian's Email*

Mother's / Guardian's Cell Phone*

Information – Parent / Guardian 2

Father's / Guardian's Name*

First Last

Father's / Guardian's Email*

Father's / Guardian's Cell Phone*

Information, Policies, and Permissions

Confidential Information

To best support you and your child(ren), please let us know of any allergies (especially medical and food allergies), physical limitations, learning challenges, special needs and/or family circumstances (recent separation, divorce, death or illness). Please contact Mary Jo (331-707-5378) or Dave Miserendino (331-707-5371) prior to the start of classes so we may learn how to support you in the care of your child(ren)’s needs and faith development. Thank you!

GENERAL PERMISSIONS

CODE OF BEHAVIOR

VIDEOS, PHOTOS, and VIRTUAL PLATFORMS

MEDICAL PERMISSION

Medical Insurance Information

Our Diocese ask for the information below to assure for child safety when they are in the care of the parish program.

Medical Insurance/Policy in the name of:

Medical Insurance Company

Policy/Identification Number

Authorized Physician

Physician Phone Number

EMERGENCY CONTACTS

Contact 1 – Name*

First Last

Contact 1 – Cell Phone*

Contact 1 – Relationship*

Contact 2 – Name*

First Last

Contact 2 – Cell Phone*

Contact 2 – Relationship*

Tuition

Our tuition includes all students in grades K-12 in the tuition/fee plan below. Please indicate how many total students you have in your family in the programs (K-5, EDGE and LIGHT-CHOSEN). ***There is also an additional Sacrament Fee for those students (ages 7 – 17) preparing to receive their Sacraments (Baptism, First Reconciliation, First Holy Communion).

Tuition Fees (Grades K – 12)*

Families with 1 child/student ($185)

Families with 2 children/students ($295)

Families with 3 or more children/students ($375)

Sacrament Fees – 1st Reconciliation/1st Communion (Ages 7 – 17)

Child/Student preparing for a sacraments. ($100)

A fee of $100 is charged for every child/student, preparing to receive the sacrament of 1st Reconciliation / 1st Communion.

After you hit SUBMIT, you will be redirected to the PAYMENT page to make payment by credit/debit card. You may indicate a FULL payment or 1/2 payment option. If tuition is a financial hardship, there is an additional option to select for Tuition Assistance. Or if you would like to submit a check or cash as payment, or have any questions, please contact Karen Schwartz in the Family Faith Formation Office at karens@olmercy.com or 331-707-5369. THANK YOU!

Please Sign Name Electronically Below*

The parties agree that this document may be electronically signed and that the electronic signatures appearing on this document are the same as handwritten signatures for the purposes of validity, enforceability and admissibility. Transmission via email is not encrypted, so if you are concerned about the security of your sensitive information, please print and fax this form, surface mail it or hand deliver it.

Family Faith Formation Registration

Family Faith Formation Registration