Register for Religious Education - The Cluster of St. John Paul II
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)
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