LITTLEST DISCIPLES - SUNDAY 11:30AM Registration 2019-20

1. STUDENT INFORMATION

All data fields are required unless otherwise noted.

Name

Address

Female/Male Female Male

Date of Birth mm/dd/yy

2019 - 2020 Grade

School

T - Shirt Size Kids X - Small Youth Small

Friend Request for Small Groups

Optional

2. FAMILY INFORMATION

Primary Parent Contact (Last, First)

Phone

This address will receive a confirmation email

Are you registered at Mary, Queen of Peace? Yes No

Language spoken at home

Emergency Contact Name

Emergency Contact Phone Number

Relationship

Alternate Pick-up Authorization (Name and Phone Number)

3. VOLUNTEER OPPORTUNITIES

Let us know how often you are available Each Session Once a Month Whenever you need me

4. OTHERS

Special Needs Information

Please identify any specific needs or challenges your child may have that require special attention by the program director or volunteer core team. Please list an identified learning disability, classroom difficulties, medical conditions, allergies, etc.

Optional

Photography Release

By submitting this on-line registration, I consent to photos taken of my child participating in Mary, Queen of Peace’s Faith Formation Program and related activities. The purpose for these photographs is to share the ministry events with the parish on the Mary, Queen of Peace website, blog, newsletters, signage, emails, etc. I recognize that my child will not be identified by name in the photos, without further consent. If you do not wish to have your child pictured at all, please write your instructions to children.family@mqp.org. Please type your initials in the box below.

Parental Permission

I hereby grant permission for my child/children to participate in Mary, Queen of Peace Children & Family Ministry Program for the 2019-2020 academic year. In the event of an emergency, I give permission to transport my child(ren) to a hospital for medical emergencies. Please type your initials in the box below.

5. ONLINE PAYMENT

Please click the link below to process your payment.

When you have completed that step, please come back to this page and type your initials below.

**Your Registration will not be processed without completing this step.**

Scholarships are available upon request.

ON-LINE PAYMENT LINK, select Faith Formation Registration:

https://mqp.weshareonline.org/FaithFormationRegistration1

Thank you for processing your registration. We are looking forward to seeing you in September. God Bless you and your family as you get settled into the new school year! Please initial below when payment is completed.

6. GOT QUESTIONS?

Please contact:

Jennie Caldwell
425.391.1178 ext 116
children.family@mqp.org

LITTLEST DISCIPLES - SUNDAY 11:30AM Registration 2019-20

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