Registration Form

Registration Form

Gender
MaleFemale


(include locality (town, city, county, etc.), region (state, province, territory, etc.), and country)

Family Contact Information

Parish Registration:
YesNo

Candidate Religious History

Has he/she ever been baptized?
YesNoI am not sure

If you answered "Yes", please provide the following information:

In what denomination was he/she baptized?
MaroniteRoman CatholicOrthodoxMelkiteOther

(include locality (town, city, county, etc.), region (state, province, territory, etc.), and country)

If candidate were baptized as a Catholic, check those sacraments he / she has already received
Penance (Confession)Eucharist (First Communion)Confirmation



IMPORTANT INFORMATION:

In an emergency, and if a parent cannot be contacted, you have my permission to contact the following person to help make decisions regarding the care for my child:



I hereby consent and authorize Father Elias KHALIL or his designated representative, to obtain and pro- vide for (Name) any and all medical care or treatment which might be- come necessary, until either parent or the emergency contact person can be reached.


I further expressly release and waive Father Elie Mikhael, his designated representative, and Saint Anthony Maronite Church, and the Eparchy of St. Maron of Brooklyn, from any liability, action, claim, cause of action which I might otherwise have i event of illness or injury during the period that (Name)is attending the KOM events.

PHOTO RELEASE (Please circle appropriate information below)

AUDIO VISUAL TAPING AND PHOTOGRAPHY CONSENT: On occasion, videotape, audio tape, slides, and photographs are taken of children and youth during church and diocesan sponsored activities. These are utilized in newsletters, websites, event promotion, advertisements and other printed media.


I consentdo not consent to the use of such materials in which my child may appear. I release the staff and volunteers of St Anthony Maronite Church and the Eparchy of St Maron of Brook- lyn, NY from any liability connected with the use of my child pictures or voice recording as part of any of the above or similar activities.