St. Mary of the Assumption Catholic Church - Online Registration - English

Date REQUIRED Please fill out this field. Please enter a date.

Envelope Number REQUIRED

This is the number on your Offertory Envelopes. If you do not know this number, please call the Parish office

Please fill out this field. Please enter an integer (number).

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Street Address 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.

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Emergency Contact Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Email REQUIRED Please fill out this field. Please enter an email address.

Child 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.

Date of birth REQUIRED Please fill out this field. Please enter valid data.

Grade in School as of September 2020 REQUIRED Please fill out this field. Please enter an integer (number) from 0 to 12.

Sacraments REQUIRED

Please select all that apply

My child has been baptized My child has made 1st Communion My child has made Confirmation My child has not received any Sacraments Please fill out this field.

Child 2

First Name Please enter valid data.

Last Name Please enter valid data.
Date of birth Please enter valid data.
Grade in School as of September 2020 Please enter an integer (number) from 0 to 12.
Sacraments
Please select all that apply
My child has been baptized My child has made 1st Communion My child has made Confirmation My child has not received any Sacraments

Child 3

First Name Please enter valid data.

Last Name Please enter valid data.
Date of birth Please enter valid data.
Grade in School as of September 2020 Please enter an integer (number) from 0 to 12.
Sacraments
Please select all that apply
My child has been baptized My child has made 1st Communion My child has made Confirmation My child has not received any Sacraments

Child 4

First Name Please enter valid data.

Last Name Please enter valid data.

Date of birth Please enter valid data.

Grade in School as of September 2020 Please enter an integer (number) from 0 to 12.

Sacraments

Please select all that apply

My child has been baptized My child has made 1st Communion My child has made Confirmation My child has not received any Sacraments

Do any of your children have special learning needs, medical conditions or allergies we need to be aware of? REQUIRED Yes No Please fill out this field.

If yes , please give the name of your child and specifiy the type of help your child needs or the conditions we need to be aware of.

My child's learning needs or medical conditions are:

Name and phone number of those authorized to pick up your child

First Name , Last Name & Phone Number REQUIRED Please fill out this field. Please enter valid data.

I will be paying Registration Fees REQUIRED Please fill out this field.

I understand all Registration Fees must be paid to complete my child's registration.
I understand all fees are non refundable.
I understand and give permission for my child/children to receive instruction on self protection during the first class of the Religious Formation Year. This instruction is provided by the Diocese of Fort Worth.
I authorize my child's temperature to be take prior to entering the school building.
I understand my child will not be permitted into the building if my child has a fever.
I understand that I must submit a copy of my child's birth certificate if my child has not yet been baptized.
I understand that I must submit a copy of my child's baptism certificate if this is their first year in Religious Formation

I aknowledge and agree to all the above Please select this field.

Email REQUIRED Please fill out this field. Please enter an email address.

ST. MARY OF THE ASSUMPTION
Catholic Church est. 1909

509 W. Magnolia Avenue ~Fort Worth, Texas 76104

Online Registration - English

Religious formation registration form