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Registracion del Participante

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Immaculate Conception Church

Location

200 Ware Ave

Towson, MD 21204

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Contact Kristen Mumaw:

410-427-4726

kmumaw@theimmaculate.org

Primero, cuéntenos sobre usted:

Información de los Padres

After completing this registration, complete the child intake form in the documents section and email it to the coordinator.

Documents

Please add the child and parents full legal names as they will appear on the certificates.

Nombre

This field is required.

Apellido

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Correo Electrónico

This field is required.

Dirección 1

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Dirección 2

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Ciudad

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Estado/Provincia

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ZIP/Código Postal

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País

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Teléfono de Contacto 1

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Teléfono de Contacto 2

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Afiliación de la iglesia local

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Other Parent First Name

This field is required.

Other Parent Last Name

This field is required.

Other Parent Email Address

This field is required.

Mother's Maiden name

This field is required.

Are parents married?

Multiple selections are allowed.

This field is required.

If not married, who has legal custody of child?

This field is required.

If not yet registered, please go here: https://www.theimmaculate.org/church/join-our-parish-2/

This field is required.

Grades K-5: Are you registered in our School of Religion Program?

This field is required.

Grades 6-12: Do you commit to attending the youth ministry program on a routine basis?

This field is required.

Click here for your FREE Friends With God Kids Activity Pack

By checking the box you will be emailed your Free Friends With God Kids Activity Pack.

You are also agreeing to receive emails about family resources from Lifetree. You can unsubscribe at any time. We value your privacy. Your information will not be shared with a third party. Lifetree is a division of Group Publishing, the creators of Group VBS and other faith-building resources. Click to learn more about Lifetree.

Cuéntanos sobre tu participante

Please include parent and child's full legal names as they will appear on the certificates.

Nombre

This field is required.

Middle Name

This field is required.

Apellido

This field is required.

Grado Entrando

This field is required.

School attending

This field is required.

Género

This field is required.

Fecha de nacimiento

This field is required.

City and State of Birth

This field is required.

Alergias

This field is required.

Preocupaciones Médicas

This field is required.

Comentarios

This field is required.

Has child been baptized? If so please list the church/faith.

This field is required.

We agree to support our child on their faith journey.

This field is required.

We agree to complete the intake form asap, and submit it quickly so that the coordinators can ensure that the program will suit our child's level.

This field is required.

We will choose a sponsor for our child by November 1st.

This field is required.

We know how important this preparation is and agree to attend all events (barring an emergency) and will work to complete outside assignments. We will talk to the coordinators immediately if there is a conflict.

This field is required.

I agree to help ensure my child attends Mass on Sundays and Holy Days of Obligation

This field is required.

I agree to register my child and actively participate in our School of Religion Program or Youth Group.

This field is required.

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