CF REG TEST

Event Information (IC-Wednesdays K-10th Grade)

Description of Event: Youth Catholic Formation
Date of Event: 9/15/26 – 5/15/27 Specific class dates will be listed on the Youth Formation calendar.
Transportation Method: None
Participant cost: $80 per student
Sponsored by: Immaculate Conception Church & St. Patrick Church
Supervised by: Catholic Formation Team members and volunteers

Event Information (SP-Sundays K-8th Grade)

Description of Event: Youth Catholic Formation
Date of Event: 9/15/26 – 5/15/27 Specific class dates will be listed on the Youth Formation calendar.
Transportation Method: None
Participant cost: $80 per student
Sponsored by: Immaculate Conception Church & St. Patrick Church
Supervised by: Catholic Formation Team members and volunteers

Event Information (SEEKERS 11th-12th Grade)

Description of Event: Youth Catholic Formation
Date of Event: 9/15/26 – 5/15/27 Specific class dates will be listed on the Youth Formation calendar.
Transportation Method: None
Participant cost: $0 per student
Sponsored by: Immaculate Conception Church & St. Patrick Church
Supervised by: Catholic Formation Team members and volunteers

Event Information (Homeschool)

Description of Event: Youth Catholic Formation
Date of Event: 9/15/26 – 5/15/27 Specific class dates will be listed on the Youth Formation calendar.
Transportation Method: None
Participant cost: $40 per student
Sponsored by: Immaculate Conception Church & St. Patrick Church
Supervised by: Catholic Formation Team members and volunteers

Do any of these apply?

All of my children share the same physician and healthcare system
All of my children are on the same health insurance with matching policy number

To save time for registering children, are any of the above TRUE statements?

Shared Physician & Insurance Information

Shared Physician Information

Shared Insurance Information

Participant Registration Section

Please fill out the form below for each child that you are registering. To add another child, please click on the “Add Child” button at the bottom of the form for more child forms.

Child Registration

Shared Physician & Insurance Form

Child's Name:

First

Last

Date of Birth:

Gender:

Grade Level (In Fall):

Formation Location Choice

Wednesdays at IC (K – 10th Grade)
Sundays at SP (K – 8th Grade Only)
Homeschool (K, 3-8, 11-12 Grades)
SEEKERS (11th & 12th Grade Only)

Special Needs (Medical, Learning Disabilities, Physical Disabilities, etc.):

Do you need to submit a Medication Consent Form for this child?

Yes

If you selected “Yes”, you need to submit a Medication Consent Form. Please download the form here, fill out the form digitally and upload the completed form on the next page. Please include your child’s name within the saved form’s filename.

Participation Permission

I consent and give my permission

I give permission for my child to participate in the above named event. My signature below indicates that I understand the risks and hazards associated with this event, including injury, illness and the rare possibility of death. I understand that I may discuss any concerns or questions I have about this event with a representative of the parish or Diocese of Superior prior to giving permission for my child to participate.

In consideration for my child’s participation, I agree to reimburse and indemnify the above named parish and the Diocese of Superior for all reasonable legal and court fees incurred by the parish/diocese in defending a lawsuit that I or my child may bring against the parish/diocese which relates to the above named event if the parish/diocese is found not legally liable by the courts and prevails in the lawsuit. If the parish/diocese is found legally liable for any injuries sustained by my child, this paragraph will not apply. I further agree to reimburse the diocese or any other agency for property damage or any bodily harm to other participants caused by my child.

Safe Environment Training Participation Permission

Yes, I would like my child to participate in the Safe Environment training described below.
No, I do not want my child to participate in the Safe Environment training described below

The Catholic Formation Department of Immaculate Conception Church & St. Patrick Church will be presenting Circle of Grace grade-level lessons to all children enrolled in Catholic Formation. This training is offered in response to the mandates of the United States Conference of Catholic Bishops Charter for the Protection of Children and Young People: Promise to Protect, Pledge to Heal. Circle of Grace was developed by the Archdiocese of Omaha and has been adopted by the Diocese of Superior as its curriculum to help keep our children safe. Parents and other caring adults want to protect children from those who might harm them, but no child can be supervised every moment of the day. This training will help your child recognize unhealthy relationships, appropriate ways to reduce the likelihood of being abused, and how to get help from others. Most importantly, this information will be presented to your child in a manner that reinforces his/her value as a person created in the image and likeness of God deserving of love and respect.

Your child’s training session will be held on 11/11/2026 at IC and 11/15/26 at SP.

I understand that if I refuse to allow my child to participate in this training, I will receive a resource packet from the parish to help me educate my child on these important issues.

Signature

Clear Signature

Child Registration

Shared Physician Form

Child's Name:

First

Last

Date of Birth:

Gender:

Grade Level (In Fall):

Formation Location Choice

Wednesdays at IC (K – 10th Grade)
Sundays at SP (K – 8th Grade Only)
Homeschool (K, 3-8, 11-12 Grades)
SEEKERS (11th & 12th Grade Only)

Special Needs (Medical, Learning Disabilities, Physical Disabilities, etc.):

Do you need to submit a Medication Consent Form for this child?

Yes

If you selected “Yes”, you need to submit a Medication Consent Form. Please download the form here, fill out the form digitally and upload the completed form on the next page. Please include your child’s name within the saved form’s filename.

Participation Permission

I consent and give my permission

I give permission for my child to participate in the above named event. My signature below indicates that I understand the risks and hazards associated with this event, including injury, illness and the rare possibility of death. I understand that I may discuss any concerns or questions I have about this event with a representative of the parish or Diocese of Superior prior to giving permission for my child to participate.

In consideration for my child’s participation, I agree to reimburse and indemnify the above named parish and the Diocese of Superior for all reasonable legal and court fees incurred by the parish/diocese in defending a lawsuit that I or my child may bring against the parish/diocese which relates to the above named event if the parish/diocese is found not legally liable by the courts and prevails in the lawsuit. If the parish/diocese is found legally liable for any injuries sustained by my child, this paragraph will not apply. I further agree to reimburse the diocese or any other agency for property damage or any bodily harm to other participants caused by my child.

Health Insurance Carrier

Policy Number

Safe Environment Training Participation Permission

Yes, I would like my child to participate in the Safe Environment training described below.
No, I do not want my child to participate in the Safe Environment training described below

The Catholic Formation Department of Immaculate Conception Church & St. Patrick Church will be presenting Circle of Grace grade-level lessons to all children enrolled in Catholic Formation. This training is offered in response to the mandates of the United States Conference of Catholic Bishops Charter for the Protection of Children and Young People: Promise to Protect, Pledge to Heal. Circle of Grace was developed by the Archdiocese of Omaha and has been adopted by the Diocese of Superior as its curriculum to help keep our children safe. Parents and other caring adults want to protect children from those who might harm them, but no child can be supervised every moment of the day. This training will help your child recognize unhealthy relationships, appropriate ways to reduce the likelihood of being abused, and how to get help from others. Most importantly, this information will be presented to your child in a manner that reinforces his/her value as a person created in the image and likeness of God deserving of love and respect.

Your child’s training session will be held on 11/11/2026 at IC and 11/15/26 at SP.

I understand that if I refuse to allow my child to participate in this training, I will receive a resource packet from the parish to help me educate my child on these important issues.

Signature

Clear Signature

Child Registration

Shared Insurance Form

Child's Name:

First

Last

Date of Birth:

Gender:

Grade Level (In Fall):

Formation Location Choice

Wednesdays at IC (K – 10th Grade)
Sundays at SP (K – 8th Grade Only)
Homeschool (K, 3-8, 11-12 Grades)
SEEKERS (11th & 12th Grade Only)

Special Needs (Medical, Learning Disabilities, Physical Disabilities, etc.):

Do you need to submit a Medication Consent Form for this child?

Yes

If you selected “Yes”, you need to submit a Medication Consent Form. Please download the form here, fill out the form digitally and upload the completed form on the next page. Please include your child’s name within the saved form’s filename.

Participation Permission

I consent and give my permission

I give permission for my child to participate in the above named event. My signature below indicates that I understand the risks and hazards associated with this event, including injury, illness and the rare possibility of death. I understand that I may discuss any concerns or questions I have about this event with a representative of the parish or Diocese of Superior prior to giving permission for my child to participate.

In consideration for my child’s participation, I agree to reimburse and indemnify the above named parish and the Diocese of Superior for all reasonable legal and court fees incurred by the parish/diocese in defending a lawsuit that I or my child may bring against the parish/diocese which relates to the above named event if the parish/diocese is found not legally liable by the courts and prevails in the lawsuit. If the parish/diocese is found legally liable for any injuries sustained by my child, this paragraph will not apply. I further agree to reimburse the diocese or any other agency for property damage or any bodily harm to other participants caused by my child.

Child's Primary Physician

First

Last

Physician Phone Number:

Health System & Location

Safe Environment Training Participation Permission

Yes, I would like my child to participate in the Safe Environment training described below.
No, I do not want my child to participate in the Safe Environment training described below

The Catholic Formation Department of Immaculate Conception Church & St. Patrick Church will be presenting Circle of Grace grade-level lessons to all children enrolled in Catholic Formation. This training is offered in response to the mandates of the United States Conference of Catholic Bishops Charter for the Protection of Children and Young People: Promise to Protect, Pledge to Heal. Circle of Grace was developed by the Archdiocese of Omaha and has been adopted by the Diocese of Superior as its curriculum to help keep our children safe. Parents and other caring adults want to protect children from those who might harm them, but no child can be supervised every moment of the day. This training will help your child recognize unhealthy relationships, appropriate ways to reduce the likelihood of being abused, and how to get help from others. Most importantly, this information will be presented to your child in a manner that reinforces his/her value as a person created in the image and likeness of God deserving of love and respect.

Your child’s training session will be held on 11/11/2026 at IC and 11/15/26 at SP.

I understand that if I refuse to allow my child to participate in this training, I will receive a resource packet from the parish to help me educate my child on these important issues.

Signature

Clear Signature

Child Registration

Full Form

Child's Name:

First

Last

Date of Birth:

Gender:

Grade Level (In Fall):

Formation Location Choice

Wednesdays at IC (K – 10th Grade)
Sundays at SP (K – 8th Grade Only)
Homeschool (K, 3-8, 11-12 Grades)
SEEKERS (11th & 12th Grade Only)

Special Needs (Medical, Learning Disabilities, Physical Disabilities, etc.):

Do you need to submit a Medication Consent Form for this child?

Yes

If you selected “Yes”, you need to submit a Medication Consent Form. Please download the form here, fill out the form digitally and upload the completed form on the next page. Please include your child’s name within the saved form’s filename.

Participation Permission

I consent and give my permission

I give permission for my child to participate in the above named event. My signature below indicates that I understand the risks and hazards associated with this event, including injury, illness and the rare possibility of death. I understand that I may discuss any concerns or questions I have about this event with a representative of the parish or Diocese of Superior prior to giving permission for my child to participate.

In consideration for my child’s participation, I agree to reimburse and indemnify the above named parish and the Diocese of Superior for all reasonable legal and court fees incurred by the parish/diocese in defending a lawsuit that I or my child may bring against the parish/diocese which relates to the above named event if the parish/diocese is found not legally liable by the courts and prevails in the lawsuit. If the parish/diocese is found legally liable for any injuries sustained by my child, this paragraph will not apply. I further agree to reimburse the diocese or any other agency for property damage or any bodily harm to other participants caused by my child.

Child's Primary Physician

First

Last

Physician Phone Number:

Health System & Location

Health Insurance Carrier

Policy Number

Safe Environment Training Participation Permission

Yes, I would like my child to participate in the Safe Environment training described below.
No, I do not want my child to participate in the Safe Environment training described below

The Catholic Formation Department of Immaculate Conception Church & St. Patrick Church will be presenting Circle of Grace grade-level lessons to all children enrolled in Catholic Formation. This training is offered in response to the mandates of the United States Conference of Catholic Bishops Charter for the Protection of Children and Young People: Promise to Protect, Pledge to Heal. Circle of Grace was developed by the Archdiocese of Omaha and has been adopted by the Diocese of Superior as its curriculum to help keep our children safe. Parents and other caring adults want to protect children from those who might harm them, but no child can be supervised every moment of the day. This training will help your child recognize unhealthy relationships, appropriate ways to reduce the likelihood of being abused, and how to get help from others. Most importantly, this information will be presented to your child in a manner that reinforces his/her value as a person created in the image and likeness of God deserving of love and respect.

Your child’s training session will be held on 11/11/2026 at IC and 11/15/26 at SP.

I understand that if I refuse to allow my child to participate in this training, I will receive a resource packet from the parish to help me educate my child on these important issues.

Signature

Clear Signature

SATURDAY	5:00 PM
SUNDAY	9:00 AM

TUESDAY	5:00 PM
WEDNESDAY	10:00 AM	8:15 AM Non-School Year
THURSDAY	8:15 AM
FRIDAY	8:15 AM

CF REG TEST

THIS PAGE IS FOR TESTING ONLY AND SHOULD NOT BE SHARED OUTSIDE OF STAFF!

Parent / Guardian #1 Contact Information

Parent / Guardian #2 Contact Information

General Information

Event Information (IC-Wednesdays K-10th Grade)

Event Information (SP-Sundays K-8th Grade)

Event Information (SEEKERS 11th-12th Grade)

Event Information (Homeschool)

Shared Physician & Insurance Information

Shared Physician Information

Shared Insurance Information

Participant Registration Section

Child Registration

Child Registration

Child Registration

Child Registration

Required Forms

Payment Section

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Make your payment to the church office:

Registration Submission