Year 2 Confirmation Registration

Please note: Year 2 students must have completed Year 1 here at Holy Angels.

: HOLY ANGELS PARISH CONFIRMATION REGISTRATION
: CONFIRMATION YEAR 2 (GRADES 10, 11, and 12) | $250 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 2024
Has your child/youth been baptized in the Catholic church?
If yes, please provide the date, church, city, and state of your child’s baptism.
Has your child/youth received First Communion?
If yes, please provide the date, church, city, and state of your child’s First Communion.
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
Family Email Address
Address, City, Zip Code
Home Phone #
Work Phone #
Cell Phone #
Mother or Guardian First and Last Name
Address, City, Zip Code (If different)
Work Phone #
Home Phone #
Cell Phone #
: PARENT OR GUARDIAN SIGNATURE
: By signing this document, I give permission for my child/youth to participate in this faith formation program.
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

: 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 authorizes and consents to Holy Angels Religious Education Staff using and publishing the name and likeness of my child/youth for publicity purposes or any other lawful purpose, including electronic media. Please enter the name of your child/youth:
: The undersigned parent releases Holy Angels Parish and staff from any liability related to such use. The parent acknowledges reading this release, having the opportunity to consider and understand its terms, and voluntarily executes it with full 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:
: At Holy Angels, we prioritize your child’s safety and well-being. The Archdiocese of Los Angeles offers the Empowering God’s Children and Young People© Safety Program to educate children and young people on personal safety through classroom lessons and activities. This program is based on catechetical principles to help them understand that God loves them and wants them to be healthy and safe.

The program will be presented to our students in April. This year’s topics include The Five Body Safety Rules, Safe and Unsafe Adults, and Internet Safety. Each lesson features video presentations, classroom discussions, individual and group activities, and a “Take Home Activity” for students to complete with a parent/guardian. A Summer Safety Lesson will also be presented at the end of the year. We encourage all parents to read the “Working Together to Prevent Child Sexual Abuse” brochure, which will be distributed at the beginning of the year.

Please complete the form below for your child/youth to participate in the program.
: I understand that to allow my child/youth to participate in the Empowering God’s Children and Young People© Safety Program, I must complete this Parent Permission Form. By doing so, I explicitly give permission for the 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.
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 conditions that restrict physical activity or require special attention or adjustments. Include conditions such as asthma or allergies (e.g., peanuts, bee stings). 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 2 Confirmation Registration

HOLY ANGELS PARISH CONFIRMATION REGISTRATION

CONFIRMATION YEAR 2 (GRADES 10, 11, and 12) | $250 per student

PARENT OR GUARDIAN INFORMATION

PARENT OR GUARDIAN SIGNATURE

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

PHOTO RELEASE: Parent Authorization, Consent and Release.

PROTECTING OUR CHILDREN:

EMERGENCY INFORMATION FORM

PARENT OR GUARDIAN SIGNATURE

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