Welcome to the 2023-2024 Faith Formation Program Registration at Our Lady Queen of Heaven

Thank you for joining us for Faith Formation at Our Lady Queen of Heaven Parish. We are excited to journey with you and your family!

Family Information

Family Last Name*

Parishioner Status*

Parishioners at Our Lady Queen of Heaven
Non-Parishioners

Best Phone Number for Contact*

Best Email for contact*

Families will be contacted twice a month as a reminder of upcoming classes and important dates. Emails will also be sent in the case of a weather closure.

Baptismal Certificate*

All 1st Time Students & 2nd Graders who were not baptized at Our Lady Queen of Heaven are required to submit a Baptismal Certificate from the parish that they were baptized at.

Parent Information

Father’s Name*

Mother’s Name*

Mother’s Maiden Name*

Address*

Second Address

Student #1 Information

Legal Name*

Nickname

Date of Birth*

Gender*

Male
Female

Grade Entering*

Which Sacraments HAS this child ALREADY received?*

No Sacraments received at this time
Baptism
First Eucharist
Confirmation

Sacraments preparing to receive this year*

Special Needs/Medical Knowledge/Information of Note*

ADD ANOTHER STUDENT TO YOUR REGISTRATION

Emergency Contact

Emergency Contact Information: Please provide an emergency contact other than a parent if neither parent can be reached.

Emergency Contact #1

Contact Name*

Relationship to child(ren)*

Phone Number*

Emergency Contact #2

Contact Name*

Relationship to child(ren)*

Phone Number*

Safe Environment

The Diocese of La Crosse provides Protect and Heal training from the Catholic perspective to participating individuals in its programs.
The substance and focus of Protect and Heal Training is as follows:
Kindergarten-Second Grade: Students will learn about their dignity (their incredible worth) as children of God and the respect that each person deserves as a child of God. Students will learn about safety, safe environment and the care that is to surround them, the difference between appropriate, kind actions and behavior that makes them feel safe, secure and loved, and inappropriate, harmful actions and behaviors that makes them feel uncomfortable or unsafe.
Grade Three-Five: Students will learn about the virtue of respect, which is based upon the dignity of each human person. Students will learn the importance of saying “no” to inappropriate, harmful actions, behavior and touch that makes them feel uncomfortable or unsafe. Children will be encouraged to tell immediately a trusted adult when these situations arise and will learn about the buddy system.
Grades Six-Eight: Students will learn about how each person, including themselves, must be treated with respect. Students will learn about, and seek to develop or further develop, the virtue of prudence-making good decisions. Students will learn practical tips for keeping themselves safe and will discuss defensive and assertive body language to protect themselves.
High School: Students will understand virtue, which are good moral habits, and vice, which are bad moral habits. Students will discuss the virtue of chastity and modesty; learn practical steps for protecting themselves and others from sexual abuse, including the ability to recognize warning signs and how to react to abuse and to the possible threat of abuse.

I acknowledge that the Diocese of La Crosse has offered my child Protect and Heal education by the Charter for the Protection of Children and Young People and by the Protect and Heal Program of the Diocese of La Crosse.*

Safe Environment Permission*

I hereby consent for my child(ren)participate in the Protect and Heal Program.
I am declining the training and do not want my student(s) to participate in the Protect and Heal Program.

Photography

Photo Permission*

I hereby consent
I hereby consent that any still or electronic image and/or audio recording, in which I or my child may appear, may be used by Our Lady Queen of Heaven. I understand that these materials are being used for promotion of Our Lady Queen of Heaven Parish. The images and/or recordings may be used to support recruitment, fundraising, evangelization and other communication efforts.
I release the staff and volunteers and I understand and agree that the use of my picture is not an invasion of privacy. Neither I, nor anyone claiming to be speaking on my behalf, will later object to the Parish's use of this/these photographs.
I hereby do not consent
I hereby do not consent that any still or electronic image and/or audio recording, in which I or my child may appear, may be used by Our Lady Queen of Heaven Parish.

Fees

Program Fees*

1 Student ($70.00)
2 Students ($135.00)
3 or more students ($195.00)

Sacramental Fees*

I have a child receiving First Eucharist this year ($30.00)
I have a student receiving Confirmation ($35.00)
I do not have a student receiving sacraments this year ($0.00)

Coupon Code

Total

$0.00

Billing Information

Name*

Credit Card*

Visa
Mastercard
American Express
Discover

Address*

Email*

Phone Number*