Facebook YouTube Phone

Search

FAITH FORMATION REGISTRATION

Please fill out each question. If it is a "Required" question and it does not pertain to you, type N/A
Por favor complete cada pregunta. Si es una pregunta "Requerida" y no le pertenece, escriba No Aplica

The maximum number of form submissions has been reached. This form is currently not available.

Father Name/ Padre Nombre: REQUIRED Please fill out this field. Please enter valid data.
Father Tel/Cell Phone/ Padre Telefono: REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
Father's Email REQUIRED Please fill out this field. Please enter an email address.
Father's Religion REQUIRED Please fill out this field. Please enter valid data.
Father's Preferred Language REQUIRED Please fill out this field. Please enter valid data.
Mother Name/ Madre Nombre: REQUIRED Please fill out this field. Please enter valid data.
Mother Tel/Cell Phone/ Madre Telefono: REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
Mother's Email REQUIRED Please fill out this field. Please enter an email address.
Mother's Religion REQUIRED Please fill out this field. Please enter valid data.
Mother's Preferred Language REQUIRED Please fill out this field. Please enter valid data.
Street Address/ Dirección 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.
Name of Emergency Contact Person / Nombre REQUIRED
Other than parent, in the event that a parent cannot be reached
Please fill out this field. Please enter valid data.
Relationship/ Relacion REQUIRED Please fill out this field. Please enter valid data.
Emergency Tel/Cell Phone/ EmergencyTelefono: REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
The following question asks how many students you are enrolling. It will give you the number of forms for each child to fill out individually.

La siguiente pregunta se refiere a cuántos estudiantes está inscribiendo . Le dará la cantidad de formularios para que cada niño complete individualmente.

St. Therese Youth Ministry / Ministerio Juvenil de Santa Teresa
- Please complete the following if you have a 6th-12th Grader who will be Participating in our Wednesday Night Youth Program.
  
  Complete lo siguiente si tiene un estudiante de 6.º a 12.º grado que participará en nuestro programa juvenil de los miércoles por la noche.
- Youth REQUIRED Please fill out this field.
- Youth 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.
  - Youth Phone Number Maximum 20 characters Please enter a phone number.
  - Youth Email REQUIRED Please fill out this field. Please enter an email address.
  - T-Shirt Size REQUIRED Please fill out this field.
  - I give permission to the St. Therese Youth Ministry Team to contact my child directly via text, email, and/or social media regarding youth nights, small groups, upcoming events, and other youth ministry-related events or information.
    
    Doy permiso al Equipo del Ministerio Juvenil de St. Therese para que se comunique con mi hijo directamente por mensaje de texto, correo electrónico y/o redes sociales con respecto a noches de jóvenes, grupos pequeños, próximos eventos y otros eventos o información relacionados con el ministerio juvenil.
    I have read and I Agree / Leo todo y estoy de acuerdo Please select this field.
- Youth 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.
  - Youth Phone Number Maximum 20 characters Please enter a phone number.
  - Youth Email REQUIRED Please fill out this field. Please enter an email address.
  - T-Shirt Size REQUIRED Please fill out this field.
  - I give permission to the St. Therese Youth Ministry Team to contact my child directly via text, email, and/or social media regarding youth nights, small groups, upcoming events, and other youth ministry-related events or information.
    
    Doy permiso al Equipo del Ministerio Juvenil de St. Therese para que se comunique con mi hijo directamente por mensaje de texto, correo electrónico y/o redes sociales con respecto a noches de jóvenes, grupos pequeños, próximos eventos y otros eventos o información relacionados con el ministerio juvenil.
    I have read and I Agree / Leo todo y estoy de acuerdo Please select this field.
- Youth 3
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Youth Phone Number Maximum 20 characters Please enter a phone number.
  - Youth Email REQUIRED Please fill out this field. Please enter an email address.
  - T-Shirt Size REQUIRED Please fill out this field.
  - I give permission to the St. Therese Youth Ministry Team to contact my child directly via text, email, and/or social media regarding youth nights, small groups, upcoming events, and other youth ministry-related events or information.
    
    Doy permiso al Equipo del Ministerio Juvenil de St. Therese para que se comunique con mi hijo directamente por mensaje de texto, correo electrónico y/o redes sociales con respecto a noches de jóvenes, grupos pequeños, próximos eventos y otros eventos o información relacionados con el ministerio juvenil.
    I have read and I Agree / Leo todo y estoy de acuerdo Please select this field.
- Youth 4
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Youth Phone Number Maximum 20 characters Please enter a phone number.
  - Youth Email REQUIRED Please fill out this field. Please enter an email address.
  - T-Shirt Size REQUIRED Please fill out this field.
  - I give permission to the St. Therese Youth Ministry Team to contact my child directly via text, email, and/or social media regarding youth nights, small groups, upcoming events, and other youth ministry-related events or information.
    
    Doy permiso al Equipo del Ministerio Juvenil de St. Therese para que se comunique con mi hijo directamente por mensaje de texto, correo electrónico y/o redes sociales con respecto a noches de jóvenes, grupos pequeños, próximos eventos y otros eventos o información relacionados con el ministerio juvenil.
    I have read and I Agree / Leo todo y estoy de acuerdo Please select this field.
Please click on the following document to read / Por favor, haga clic en los siguientes documentos para que diga:

Protecting God's Children
(PRINT and RETURN SLIP to Faith Formation office if you DON'T PERMIT your child/children to attend this class /
IMPRIMIR y DEVOLVER LA COPIA a la oficina de Educación Religiosa si NO PERMITE que su hijo(s) asista a esta clase)
PERMISSION & LIABILITY WAIVER
I give permission for my child(ren) to participate in the St. Therese Faith Formation Program, from September 8, 2024 – May 4, 2025. I hereby waive and release any and all rights and claims or damages which I may have against St. Therese of Lisieux Parish, the Diocese of Knoxville, and all of their agents, servants, and employees, for any and all injuries which my child(ren) may incur while taking part in your program. This release also encompasses any injuries which may be sustained while traveling to and from participation in your program. As a parent, I understand it is my responsibility to pick up my child(ren) at the predetermined time. I also understand that if my child(ren) becomes ill or destructive, the provided "EMERGENCY CONTACT" will be called to take my child home.

PERMISO Y RENUNCIA DE RESPONSABILIDAD
Doy permiso para que mi(s) hijo(s) participe(n) en el Programa de formación en la fe de St. Therese, desde el 8 de septiembre de 2024 hasta el 4 de mayo de 2025. Por la presente, renuncio y libero todos los derechos y reclamos o daños que pueda tener contra la Parroquia de St. Therese of Lisieux, la Diócesis de Knoxville y todos sus agentes, sirvientes y empleados, por cualquier lesión en la que mi(s) hijo(s) pueda(n) sufrir mientras participa en su programa. Este comunicado también abarca cualquier lesión que pueda sufrir durante el viaje hacia y desde la participación en su programa. Como padre, entiendo que es mi responsabilidad recoger a mi(s) hijo(s) a la hora predeterminada. También entiendo que si mi(s) hijo(s) se enferma(n) o es destructivo(a), se llamará al "CONTACTO DE EMERGENCIA" proporcionado para llevar a mi hijo a casa.
I have read and I Agree / Leo todo y estoy de acuerdo Please select this field.
MEDICAL TREATMENT (PLEASE SELECT ONE) - TRATAMIENTO MÉDICO (SELECCIONE UNO) REQUIRED I hereby grant permission for non-prescription medication (such as Tylenol, Advil, throat lozenges, and cough syrup) to be given to my child(ren), if deemed advisable. No medication of any type whether prescription or non-prescription may be administered to my child(ren) unless the situation is life-threatening and emergency treatment is required. Please fill out this field.
AUDIO/VIDEO PHOTO RELEASE
I hereby agree to have Audio/Video and Photographs taken of me and my child(ren) kept on file by St. Therese Catholic Church on the following date(s) 9/1/2024 – 9/1/2025 while participating in St. Therese Faith Formation Program. I understand that the audio sound bites and images shall be exclusively owned by St. Therese Catholic Church, and it may be used for the purposes of promoting the St. Therese Faith Formation Program or another development program of the Parish. St. Therese Catholic Church made no representations or other promises to me regarding quality or possible distortion of this material.
I hereby expressly grant all rights, in perpetuity, for the use of all or any part of the sound or video images taken of me or my child(ren) on the above dates. I acknowledge that the audio and video images have been taken free of charge and without a professional fee or any other compensation.

I further acknowledge that I or my child(ren) shall receive no royalties, residual compensation, or any other consideration of any sort from any party at any time, as a result of the audio and video being taken or arising from the subsequent reproduction or distribution of the audio and video taken on the above date. I expressly waive and relinquish without recourse all rights, interests, and claims that I and my child(ren) may now have or may have at any future time in the audio and video taken on the above date. I expressly waive notice of distribution or redistribution or any right of approval of the material taken on the above date.

I hereby grant St. Therese Catholic Church my permission to publish my name, my child(ren) name, and use my likeness or my child(ren) likeness that it manufactures from the material taken on the above date. This permission extends to St. Therese Catholic Church and any subsequent party which the parish may designate that is involved in the reproduction and distribution of this material.

I have read the above terms and conditions of this release. I understand the contents of this release and that I am waiving and relinquishing all rights that I or my child(ren) may have as set forth above.
I have read and I Agree / Leo todo y estoy de acuerdo Please select this field.
FAMILY COMMITMENT OF SUPPORT
I, together with my family, commit to support our child/children in faith formation in ways such as:
Yo, junto con mi familia, comprometemos a apoyar a nuestro(s) niño(s) en su formación de fe de forma tales como:

                           Going to Mass every Sunday
                            Ir a misa todos los domingos
                            Attending workshop/session/meetings
                            Asistira talleres/sesiones/reuniones
                            Praying together and doing other acts of Christian faith at home
                            Orando juntos y hacienda otros actos de fe Cristiana en casa

I have read and I Agree / Leo todo y estoy de acuerdo Please select this field.
Print signature of parent/guardian / Imprimir firma del padre / tutor REQUIRED Please fill out this field. Please enter valid data.
PAYMENT INFORMATION / INFORMACIÓN DEL PAGO:
1) General Faith Formation Fee: $30/child, maximum of $90/family

Cuota general de formación en la fe: $30/niño, máximo de $90/familia

2) Additional Sacrament Fee: $30/child

Tarifa de sacramento adicional: $ 30/niño
3) Additional Youth Ministry Fee: $15/child
Cuota Adicional del Ministerio Juvenil: $15/niño

Please bring payment to the Faith Formation Office or pay online ASAP!
¡Lleve el pago a la Oficina de Formación de Fe o pague en línea lo antes posible!

Submit

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.