Year 1 Confirmation Registration - Non-Parishioners

Please email your Baptism and First Communion certificates to [email protected]. After you have submitted your registration, you will be redirected to a secure site to make your payment. Thank you.

: HOLY ANGELS PARISH CONFIRMATION REGISTRATION FOR NON-PARISHIONERS
: CONFIRMATION YEAR 1 (GRADES 9, 10, and 11) | $300 per student
: Please fill out a separate form for each youth.
First Name, Middle Initial, Last Name
Date of Birth
Age
Gender
Name of School where enrolled
City
Grade as of September 2023
What is the name of the parish your family is registered at?
For how many years has your family been registered at the above parish?
Has your child/youth been baptized in the Catholic church?
Has your child/youth received First Communion?
If Yes, please add the date, Church, city, and state where your child received First Communion.
: Baptismal certificate and First Communion certificate copies must be attached for Confirmation students.
What is the last year of Religious Education your child/youth has attended?
Living Arrangements
Are there any custody issues or a restraining order in place?
: If “yes”, enclose a copy of the most recent applicable court order(s).
Given the nature of the program, does your child/youth have any physical, mental, emotional, cognitive, or other limitations or restrictions that would require the parish to make a minor adjustment to enable your child/youth to participate?
If “yes”, what type of restriction does your child/youth have or what adjustment(s) will be needed?

: PARENT OR GUARDIAN INFORMATION
Father or Guardian First and Last Name
Email Address
Address, City, Zip Code
Home Phone #
Work Phone #
Cell Phone #
Mother or Guardian First and Last Name
Email Address
Address, City, Zip Code (If different)
Work Phone #
Home Phone #
Cell Phone #
: PARENT OR GUARDIAN SIGNATURE
: I give my child/youth permission to participate in this faith formation program by signing this document,
Signature (Type your full name to sign this form)
Date
: EMERGENCY CONTACT INFORMATION (CONTACTS MUST BE INDIVIDUALS OTHER THAN PARENTS)
NAME
RELATIONSHIP
HOME PHONE
CELL PHONE
: PERSONS AUTHORIZED TO PICK UP YOUTH OTHER THAN PARENTS:
NAME
RELATIONSHIP
CELL PHONE

: PHOTO RELEASE: Parent Authorization, Consent and Release.
: PLEASE NOTE: This page has TWO separate signature lines. Please read and complete each area.
The undersigned parent hereby authorizes and consents that Holy Angels Religious Education Staff be permitted to use and publish for publicity purposes the name and likeness of my child/youth, or for any other lawful purpose whatsoever, including electronic media. Please enter the name of your child/youth:
: The undersigned parent hereby releases Holy Angels Parish and staff from liability concerning such use.
The parent acknowledges having read this release, having the opportunity to consider and understand its terms, and does hereby execute it voluntarily with knowledge of its significance.
Parent / Guardian Signature: (Please type your full name to sign and give consent to the Photo Release.
Date
: PROTECTING OUR CHILDREN:
: We at Holy Angels are committed to your child’s safety and well-being. The Archdiocese of Los Angeles provides the Empowering God’s Children and Young People© Safety Program as an ongoing effort to educate children and young people through classroom lessons and activities on ways to maintain their safety. It is based on catechetical principles to help them know God loves them and wants them to be healthy and safe.

A VIRTUS facilitator will present the Empowering God’s Children and Young People© Safety Program to our students in April. This year’s lesson topics include The Five Body Safety Rules, Safe and Unsafe Adults, and Internet Safety. Each lesson includes video presentations, classroom discussions, individual and group activities, and a “Take Home Activity” for students to complete with a parent/guardian. We will also present a Summer Safety Lesson at the end of each year. We encourage all parents to read the “Working Together to Prevent Child Sexual Abuse” brochure, which you will receive at the beginning of the year.

Please complete the form below for your child/youth to participate in the program.
: I understand that for my child/youth to participate in the Empowering God’s Children and Young People© Safety Program, I need to fill out this Parent Permission Form. I explicitly permit the Empowering God Children and Young People© Safety Program to be presented to my child/youth.
Youth's Name
Parent/Guardian Signature: (Please type full name to sign and consent to the above "Protecting Our Children."
Date
: EMERGENCY INFORMATION FORM
: A separate form must be completed for each youth.
: IF/WHEN WE ARE ABLE TO HAVE IN-PERSON MEETINGS, WE NEED THE FOLLOWING INFORMATION:
Youth Full Name
: If a parent or guardian can’t be reached in an emergency, please contact:

First and Last Name
Relationship to youth
Emergency contact phone #
Name of Family Doctor
Family Doctor's Phone #
Does your child/youth take any medications?
List any medical condition which restricts physical activity or requires special attention or minor adjustments. Include conditions such as asthma or allergies (e.g. peanuts, bee stings, etc.) If none, please indicate “none”.
If “yes”, please provide a list.
: PARENT OR GUARDIAN SIGNATURE
: By signing this form, I understand that the parish does not assume responsibility for the payment of physicians. However, in an emergency, the parish may choose a physician. In an emergency, I give the parish permission to have my child/youth receive medical treatment.
Signature (Please type your full name to sign)
Date

Holy Angels Church, Arcadia

Year 1 Confirmation Registration - Non-Parishioners

HOLY ANGELS PARISH CONFIRMATION REGISTRATION FOR NON-PARISHIONERS

CONFIRMATION YEAR 1 (GRADES 9, 10, and 11) | $300 per student

PARENT OR GUARDIAN INFORMATION

PARENT OR GUARDIAN SIGNATURE

EMERGENCY CONTACT INFORMATION (CONTACTS MUST BE INDIVIDUALS OTHER THAN PARENTS)

PERSONS AUTHORIZED TO PICK UP YOUTH OTHER THAN PARENTS:

PHOTO RELEASE: Parent Authorization, Consent and Release.

PROTECTING OUR CHILDREN:

EMERGENCY INFORMATION FORM

PARENT OR GUARDIAN SIGNATURE

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