TO REGISTERFOR FAITH FORMATION CLICK ON THE "REGISTRATION" LINK ON THE HOME PAGE.

All Saints Faith Formation Program

25 School Street Somersville, Ct. 06072

860-763-0-348

Registration form 2021-2022

Registration fees: 1 child/ $60, 2 children, $110, 3 or more children $170.00

     New registration            Returning

The Parent/Guardian Information should be filled out for BOTH the New Families/Students as well as the returning Students. There is an additional page to continue registering students.

PARENT/GUARDIAN INFORMATION

Father/Guardian Name

Address/City/State and Zip:

Home Phone         Cell Phone

Email Address

Mother/Guardian Name

Address/City/State and Zip: (If same as above, write same)

Home Phone           Cell Phone

Email Address

** Emergency Contact Person — Name

Phone Number/s How related

Student Information          New            Returning

Last Name

Address City/State/Zip

Date of Birth                                                    Age                        Grade entered this fall

Allergies/Special Needs

** *( This section is to be filled out for new students only )

Where was your child Baptized?

Did they make their Reconciliation (Where)?

Did they receive their First Eucharist (Where )?

We will need a copy of their Baptismal and Eucharist Certificates. If you cannot find them, please call the church where they received the sacrament.

FOR ADDITIONAL STUDENTS/CHILDREN

Student Information            New             Returning

Last Name

AddressCity/State/Zip

Date of Birth                                                    Age                        Grade entered this fall

Allergies/SpeciaI Needs

***(This section is to be filled out for )

Where was your child Baptized?

Did they make their Reconciliation (Where)?

Did they receive their First Eucharist (Where )?

We will need a copy of their Baptismal and Eucharist Certificates. If you cannot find them, please call the church where they received the sacrament.

Student Information         New            Returning

Last Name  First

Address City/State/Zip

Date of Birth AgeGrade entered this fall

Allergies/SpeciaI Needs

***(This section is to be filled out for new students only )

Where was your child Baptized?

Did they make their Reconciliation (Where)?

Did they receive their First Eucharist (Where )?

We will need a copy of their Baptismal and Eucharist Certificates. If you cannot find them, please cal/ the church where they received the sacrament.

Student Information            New             Returning

Last Name

Address City/State/Zip

Date of Birth                                                   Age                        Grade entered this fall

Allergies/Special Needs section is to be filled out for new-students-gn!y )

Where was your child Baptized?

Did they make their Reconciliation (Where)?

Did they receive their First Eucharist (Where )?

We will need a copy of their Baptismal and Eucharist Certificates. If you cannot find them, please cal/ the church where they received the sacrament.

DIOCESE OF NORWICH

VIDEO CONFERENCING PERMISSION SLIP

PROVIDING CONSENT & RELEASE OF CLAIMS

Despite the COVID-19 pandemic, the Diocese of Norwich continues to serve the children and youth of (Add your church). In some instances, Parish program(s) are providing virtual programming and content for participants, whereby staff will facilitate program activities through online platforms. Such program(s) will use software, tools, and computer applications provided by third-parties that participants, parents/legal guardians, volunteers, and/or staff will access via the internet and use for purposes of communication, programming, and potential content creation.

These platforms include virtual video conferencing. Completion of this Form indicates your consent and release for your child to participate in the program(s) and utilize the online applications for distancebased, virtual program purposes. Please be aware that each video conference application collects information about its users and has its own privacy terms and conditions to which users must adhere and which neither the parish nor diocese can control or assume responsibility. Please review these carefully before registering your child. Our commitment to keeping the children and youth we serve safe is always our number one priority. To that end, we will actively monitor participant activity. All online activities contemplated hereunder must also comply with the Diocese of Norwich- Office for Safe

Environment Pastoral Code of Conduct as well as the Policy for Video Conferencing with Young People.

Permission to Participate:

I grant permission for my child-youth, to participate

Child's name in online Catechetical/Youth Ministry events during the 2021-2022 church school year. All online classes, programs, events, etc. will be monitored by at least 2 safe environment certified adults at all times. I have read this Consent and Release Form and have had the opportunity to consider its terms and understand them. I verify that I have read and voluntarily agree to the terms and conditions of the Consent and Release Form — Policy for Video Conferencing with Young People. On behalf of my child and myself, I further hereby hold harmless, release and forever discharge the Diocese of Norwich and the Parish, along with their respective employees, agents, licensees, and legal representatives from, and shall indemnify them against, all claims, demands, and causes of action which l, my heirs, representatives, executors, administrators or any other person(s) acting on my behalf or on behalf of my estate have or may have by reason of my Child's participation in the program(s) and through my authorization, consent and release herein. I have read this Consent and Release Form, I fully understand it, and I voluntarily agree to be bound by its terms. I represent and certify that I am the parent or legal guardian of the child named above.

Parent/Guardian Name:

Signature:

Email: Cell Phone:

Address:                                                                 City:                         State: Connecticut

ALL SAINTS PARISH

PARENTAL/GUARDIAN COVID-19

CONSENT FORM AND LIABILITY WAIVER

Participant's name:

Birth date:                                                                                                Sex:

Parent/Guardian's name:

Home address:

Cell phone .                                                                     Home phone:

The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and as a result, social distancing is recommended. All Saints Parish will follow state and local standards of conduct and has put in place reasonable preventative measures to reduce the spread of COVID-19 at its All Saints Faith Formation program. However, even though such standards will be followed and reasonable measures put into place, All Saints Parish cannot guarantee that you or your child(ren) will not become infected with COVID-19. Fufther, attending the All Saints Faith Formation program could increase your risk and your child(ren)'s risk of contracting COVID-19.

By signing this agreement, I acknowledge the contagious nature of COVID-19 and that my child and I may be exposed to or infected by COVID-19 by participating in the All Saints Faith Formation program and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID- 19 at All Saints Faith Formation program may result from the actions, omissions, or negligence of myself and others, including, but not limited to, All Saints Church employees, volunteers, and program participants and their families.

Considering the foregoing, however, I,grant permission for my child,to partlupate in this parish, notwithstandingID-19 virus and group activities.

I confirm that I have provided complete Medical Information and Consent to the parish.

I further agree on behalf of myself, my child named herein, and my spouse, our heirs, successors, and assigns, to release, indemnify, and hold harmless All Saints Church and The Roman Catholic Diocese of Norwich, their members, directors, officers, employees, agents and representatives ("Indemnitees") associated with the event arising from or in connection with the negligent acts or omissions of the Indemnitees ONLY in regard to prevention of the spread of the COVID-19 virus. I SPECIFICALLY ACKNOWLEDGE AND AGREE TO THE FOREGOING.

Signature: Dat

All Saints Faith Formation Program

25 School Street Somersville, Ct. 06072

860-763-0-348

Registration form 2021-2022

Registration fees: 1 child/ $60, 2 children, $110, 3 or more children $170.00

     New registration            Returning

The Parent/Guardian Information should be filled out for BOTH the New Families/Students as well as the returning Students. There is an additional page to continue registering students.

PARENT/GUARDIAN INFORMATION

Father/Guardian Name

Address/City/State and Zip:

Home Phone         Cell Phone

Email Address

Mother/Guardian Name

Address/City/State and Zip: (If same as above, write same)

Home Phone           Cell Phone

Email Address

** Emergency Contact Person — Name

Phone Number/s How related

Student Information          New            Returning

Last Name

Address City/State/Zip

Date of Birth                                                    Age                        Grade entered this fall

Allergies/Special Needs

** *( This section is to be filled out for new students only )

Where was your child Baptized?

Did they make their Reconciliation (Where)?

Did they receive their First Eucharist (Where )?

We will need a copy of their Baptismal and Eucharist Certificates. If you cannot find them, please call the church where they received the sacrament.

FOR ADDITIONAL STUDENTS/CHILDREN

Student Information            New             Returning

Last Name

AddressCity/State/Zip

Date of Birth                                                    Age                        Grade entered this fall

Allergies/SpeciaI Needs

***(This section is to be filled out for )

Where was your child Baptized?

Did they make their Reconciliation (Where)?

Did they receive their First Eucharist (Where )?

We will need a copy of their Baptismal and Eucharist Certificates. If you cannot find them, please call the church where they received the sacrament.

Student Information         New            Returning

Last Name  First

Address City/State/Zip

Date of Birth AgeGrade entered this fall

Allergies/SpeciaI Needs

***(This section is to be filled out for new students only )

Where was your child Baptized?

Did they make their Reconciliation (Where)?

Did they receive their First Eucharist (Where )?

We will need a copy of their Baptismal and Eucharist Certificates. If you cannot find them, please cal/ the church where they received the sacrament.

Student Information            New             Returning

Last Name

Address City/State/Zip

Date of Birth                                                   Age                        Grade entered this fall

Allergies/Special Needs section is to be filled out for new-students-gn!y )

Where was your child Baptized?

Did they make their Reconciliation (Where)?

Did they receive their First Eucharist (Where )?

We will need a copy of their Baptismal and Eucharist Certificates. If you cannot find them, please cal/ the church where they received the sacrament.

DIOCESE OF NORWICH

VIDEO CONFERENCING PERMISSION SLIP

PROVIDING CONSENT & RELEASE OF CLAIMS

Despite the COVID-19 pandemic, the Diocese of Norwich continues to serve the children and youth of (Add your church). In some instances, Parish program(s) are providing virtual programming and content for participants, whereby staff will facilitate program activities through online platforms. Such program(s) will use software, tools, and computer applications provided by third-parties that participants, parents/legal guardians, volunteers, and/or staff will access via the internet and use for purposes of communication, programming, and potential content creation.

These platforms include virtual video conferencing. Completion of this Form indicates your consent and release for your child to participate in the program(s) and utilize the online applications for distancebased, virtual program purposes. Please be aware that each video conference application collects information about its users and has its own privacy terms and conditions to which users must adhere and which neither the parish nor diocese can control or assume responsibility. Please review these carefully before registering your child. Our commitment to keeping the children and youth we serve safe is always our number one priority. To that end, we will actively monitor participant activity. All online activities contemplated hereunder must also comply with the Diocese of Norwich- Office for Safe

Environment Pastoral Code of Conduct as well as the Policy for Video Conferencing with Young People.

Permission to Participate:

I grant permission for my child-youth, to participate

Child's name in online Catechetical/Youth Ministry events during the 2021-2022 church school year. All online classes, programs, events, etc. will be monitored by at least 2 safe environment certified adults at all times. I have read this Consent and Release Form and have had the opportunity to consider its terms and understand them. I verify that I have read and voluntarily agree to the terms and conditions of the Consent and Release Form — Policy for Video Conferencing with Young People. On behalf of my child and myself, I further hereby hold harmless, release and forever discharge the Diocese of Norwich and the Parish, along with their respective employees, agents, licensees, and legal representatives from, and shall indemnify them against, all claims, demands, and causes of action which l, my heirs, representatives, executors, administrators or any other person(s) acting on my behalf or on behalf of my estate have or may have by reason of my Child's participation in the program(s) and through my authorization, consent and release herein. I have read this Consent and Release Form, I fully understand it, and I voluntarily agree to be bound by its terms. I represent and certify that I am the parent or legal guardian of the child named above.

Parent/Guardian Name:

Signature:

Email: Cell Phone:

Address:                                                                 City:                         State: Connecticut

ALL SAINTS PARISH

PARENTAL/GUARDIAN COVID-19

CONSENT FORM AND LIABILITY WAIVER

Participant's name:

Birth date:                                                                                                Sex:

Parent/Guardian's name:

Home address:

Cell phone .                                                                     Home phone:

The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and as a result, social distancing is recommended. All Saints Parish will follow state and local standards of conduct and has put in place reasonable preventative measures to reduce the spread of COVID-19 at its All Saints Faith Formation program. However, even though such standards will be followed and reasonable measures put into place, All Saints Parish cannot guarantee that you or your child(ren) will not become infected with COVID-19. Fufther, attending the All Saints Faith Formation program could increase your risk and your child(ren)'s risk of contracting COVID-19.

By signing this agreement, I acknowledge the contagious nature of COVID-19 and that my child and I may be exposed to or infected by COVID-19 by participating in the All Saints Faith Formation program and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID- 19 at All Saints Faith Formation program may result from the actions, omissions, or negligence of myself and others, including, but not limited to, All Saints Church employees, volunteers, and program participants and their families.

Considering the foregoing, however, I,grant permission for my child,to partlupate in this parish, notwithstandingID-19 virus and group activities.

I confirm that I have provided complete Medical Information and Consent to the parish.

I further agree on behalf of myself, my child named herein, and my spouse, our heirs, successors, and assigns, to release, indemnify, and hold harmless All Saints Church and The Roman Catholic Diocese of Norwich, their members, directors, officers, employees, agents and representatives ("Indemnitees") associated with the event arising from or in connection with the negligent acts or omissions of the Indemnitees ONLY in regard to prevention of the spread of the COVID-19 virus. I SPECIFICALLY ACKNOWLEDGE AND AGREE TO THE FOREGOING.

Signature: Dat