St. John Paul II Parish Religious Education-Registration for
2015-16 Program
3110 17 Mile Rd.
Cedar Springs, MI 49319
616-696-3904
www.jp2-mqa.org
FAMILY LAST NAME ________________________________________________________
Address: _____________________________________________________________________
Home phone: __________________________________ Email: _________________________
Home Parish: ___________________________
(Non-parishioner fee-$50 per student)
--------------------------------------------------------------------------------------------------------------------------Parent/Guardian Information
1. Name: ______________________________
Cell Phone: __________________________
Email: ______________________________
Relationship: _________________________
Work Phone: _________________________
Occupation: _________________________
2. Name: ______________________________
Cell Phone: __________________________
Email: ______________________________
Relationship: _________________________
Work Phone: _________________________
Occupation: _________________________
-----------------------------------------------------------------------------------------------------------------------------------------------Student Information
1. Name ______________________________
Grade ____________
Sacraments
Baptism
Eucharist
Date
___________________
___________________
Birthdate ____________________________
School ______________________________
Parish
____________________________________
____________________________________
Allergies, Health issues, comments, etc…___________________________________________________
2. Name ______________________________
Grade ____________
Sacraments
Baptism
Eucharist
Date
___________________
___________________
Birthdate ____________________________
School ______________________________
Parish
____________________________________
____________________________________
Allergies, Health issues, comments, etc…___________________________________________________
3. Name ______________________________
Grade ____________
Sacraments
Baptism
Eucharist
Date
___________________
___________________
Birthdate ____________________________
School ______________________________
Parish
____________________________________
____________________________________
Allergies, Health issues, comments, etc…___________________________________________________
4. Name ______________________________
Grade ____________
Sacraments
Baptism
Eucharist
Date
___________________
___________________
Birthdate ____________________________
School ______________________________
Parish
____________________________________
____________________________________
Allergies, Health issues, comments, etc…___________________________________________________
PRAYER PARTNER PERMISSION (to be signed by parent or legal guardian)
I, _____________________, the parent and legal guardian of _______________________________________,
hereby give my child(ren) permission to participate in the SJP2 Prayer Partner Program. I understand that my child’s
name will be given to a member of SJP2 Parish and the parishioner will be asked to pray for my child throughout
the year. I further understand that this individual may leave notes of spiritual encouragement for my child at SJP2,
which will be delivered to my child during Religious Education classes.
Date ___________________________
Signed _______________________________________________
MEDICAL RELEASE (to be signed by parent or legal guardian)
Family physician _________________________________________ Phone ____________________________
Address __________________________________________________________________________________
Health Insurance Company ___________________________________________________________________
Insurance Company Phone _________________________ Policy Holder Name _________________________
Contract Number _________________________ Group Number ____________________________________
I authorize the person who presents the minor to sign the Acknowledgement of Receipt of Notice of Privacy Rights
that may be presented by the physician or health care facility. This authorization is completed and signed of my own
free will with the sole purpose of authorizing medical treatment deemed necessary and appropriate by the treating
physician.
Date _____________________________________ Signed __________________________________________
MEDIA RELEASE (to be signed by parent or legal guardian)
I give my permission to St. John Paul II parish to use, without prior notice, my name (or my child’s name), city and
state, and/or photograph, videotape, website photos, and/or any other likeness for publicity and to use statements
made by or attributed to me (or my child) relating to the Catholic Diocese of Grand Rapids for this or similar
promotions and grant to St. John Paul II Parish any and all rights to said use without compensation. It is my
understanding that my signature below releases any and all claims against the catholic Diocese of Grand Rapids
related to or arising out of the diocese’s use of this media relations/promotional material(s).
Date ___________________________________
Signed _________________________________________
Relationship to the student ___________________________________________________________________
__________
I do not give St. John Paul II Parish permission to use photographs of my family.
STEWARDSHIP OPPORTUNITIES AT ST. JOHN PAUL II PARISH
Stewardship is an integral part of parish life at St. John Paul II. To be a thriving parish, we need the involvement of all. Listed
below are a few of the opportunities that are available at St. John Paul II Parish. Please prayerfully consider how you might
become involved in the community with your family and check the area(s) of interest. Thank you!
Early Childhood
_____ Sunday Nursery at 10:30am Mass (once a month or every two months)
_____ Sunday Children’s Liturgy of the Word at 10:30am Mass (once a month or every two months)
_____ Pre-K/Kindergarten Religious Education helper (at Religious Education, as needed)
Sunday Liturgy
Special Events
_____ Lector
_____ Parish Dinners (serving, cooking, set up)
_____ Extraordinary Minister of Holy Communion
_____ Vacation Bible School (group or center leader)
_____ Usher/Greeter
_____ Fundraising (for various groups/as needed)
_____ Altar Server (3rd grade or older)
_____ Liturgical Art and Environment Committee
(preparing sanctuary for worship)
_____ Music Ministry (Cantor/Choir)
Middle/High School Ministry
_____ Retreat Volunteer (plan/implement)
_____ Small Group facilitator (discussion groups)
_____ Building and Grounds Committee
(planning for maintenance of grounds)
_____ God’s Kitchen Volunteer (serve meals)
_____ Take a Meal Ministry (cook meal and deliver)
_____ Group outing chaperone (field trips)
_____ Bring Communion to the Sick (homebound
parishioners or to Metron Nursing Home)
_____ Set-up/Clean-up Volunteer (for events)
_____ Daughters of Mary (Women’s group)
_____ Graduation Breakfast Volunteer (cook)
_____ Knights of Columbus (Men’s group)