2021-2022 Registration
St. John Neumann Youth Faith Formation

$30 Late Fee for Registrations made after July 7, 2021

Fields marked with * are required

Today's Date*:  

Family's Parish*:   SJN    Other (Contact Youth Formation Office)  

Family Last Name*: 

Mailing Address*:

City*:    Zip Code*:

Home Phone*: ( ) -

Parents / Guardians
* You must provide a name, cell phone and email for at least one parent / guardian below.

Father Full Name:    Father's Cell Phone: ( ) -    Father's Email:

Mother Full Name:    Mother's Cell Phone: ( ) -    Mother's Email:

Child(ren) Live With
Both Parents    Mother    Father    Other:

Non-Parental Emergency Contact
Name*:    Relationship*:

Home Phone*: ( ) -    Cell Phone*: ( ) -

Family Volunteer Missionary Information
Name: is interested in assisting in the following way(s):

Catechist (Grades 1 – 5) Dinners and Games Leader (Grade 6 – 8)
Special Needs Mentor Catechist Small Group Leader (Grade 6 – 8, guys or girls)
Hospitality Help (one Sun or Wed per month) High School Leader
All volunteers must fulfill the formation and safe environment requirements of the Rockford Diocese

***Youth Faith Formation classes run September 2021 – May 2022. Registration is not a guarantee. Sessions are assigned on a first-come, first-served basis, based on volunteers who have stepped forward and limits to class size***

In first year of attendance, please submit photocopy of baptismal certificate(s) for all children registered.
Student Information
Full Name:    Grade for 2021-2022:    Attended last year? Yes    No

School: Birth date:    

Student has already celebrated:   Baptism    1st Reconciliation    1st Communion    Confirmation

Sessions (choose all that apply):

Preschool and Kindergarten 6th – 8th Grade Wednesdays
Grades 1, 3, 4, & 5 Sundays and at home 6th – 8th Grade Home Study
Grades 1, 3, 4, & 5 Wednesdays and at home High School Youth Group     Adult t-shirt size:
Grades 1, 3, 4, & 5 all at home High School Confirmation Prep Independent Study
Grade 2 Sundays Special Needs
Grade 2 Wednesdays
Grade 2 all at home
Do any of the registered children have allergies or health, behavioral, or developmental concerns, etc.?
If so, please explain below. If your child has an education plan in school, it would be helpful to know
the basics of this to assist the child better in the classes. If your child needs to carry an EPI pen or other medications, please indicate this below.



For more information about our programs, including the 2021-2022 calendar once finalized,
click on: Youth Faith Formation Program Information.

***Youth Faith Formation classes run September 2021 – May 2022. Registration is not a guarantee. Sessions are assigned on a
first-come, first-served basis, based on volunteers who have stepped forward and limits to class size***

Youth Permission Slip
1. Consent: I grant my permission for my child(ren) to attend and participate in St. John Neumann’s youth formation programs, (hereinafter referred to as "Activity") to be held at St. John Neumann Catholic Church, 2900 E. Main Street, Saint Charles, IL 60174, on September 1, 2021, through August 31, 2022.

2. Student Cooperation: My child agrees to abide by all the rules of aforementioned Activity and to obey the staff in charge of this Activity. The Parish and Diocese will not be liable for my child's failure to cooperate and/or to abide by the rules. Any infraction of the rules may result in the immediate dismissal of my child from the Activity at my expense and without refund to me of the costs paid for the Activity.

3. First-Aid/Emergency Treatment: I authorize the Parish and Diocese and its employees and volunteers to administer first-aid to my child if deemed necessary and appropriate to preserve the life, limb or well-being of my child. I authorize the Parish and Diocese to contact and engage medical personnel and arrange for emergency treatment of my child, including transportation for medical, dental, surgical or hospital care or diagnosis, and I consent to that treatment for my child. I agree that I am financially responsible for such medical treatment.

4. Administration of Medication provided by parent/guardian of child: If my child needs to take prescription or non-prescription medication during this Activity, I have provided the medication in its original container. I give permission to an adult employee to administer the medication or assist in the administration of the medication to my child in the dosage prescribed by the prescription or, for non-prescription medication, the dosage recommended on the container by the manufacturer. If there are explicit instructions for this medication, I state them here:


5. Videotaping and Still Photography: Video and still photographs may be taken during this program. This authorization form constitutes permission for my child(ren)’s participation in the videotape and /or still photographs, which may be used for future promotional efforts, including the St. John Neumann and Diocese of Rockford websites, bulletin, and the Observer diocesan newspaper, and other flyers, posters, and/or videos. If you do not give photography or video permission, check here and attached a photo of your child: I do not give permission for videotaping or photography

6. Release: I hereby release and discharge the Diocese of Rockford and its Bishop, and the Parish, and the officers, directors, employees, and volunteers of same, from all claims for personal injuries or property damage that I or my child may suffer while my child is attending and/or participating in the Activity, unless the injuries or damage resulted from willful misconduct of the Diocese, the Parish, or its employees. If I have provided medication for my child to take during this Activity, I hereby release and discharge the Diocese of Rockford and its Bishop, and the Parish, and the officers, directors, employees, and volunteers of same, from all claims for personal injuries or property damage that I or my child may suffer as a result of the administration of or lack of administration of or assistance in or lack of assistance in the administration of said medication to my child, whether by my child and/or an adult employee and/or an adult volunteer; unless the injuries or damage resulted from willful misconduct of the Diocese, the Parish, or its employees.

Date*:     Parent/Guardian’s Signature (type full name)*:

Youth Faith Formation Family – Covenant of Expectations
St. John Neumann feels it important to state these expectations so that we all recognize the dignity inherent in each of us.

Rights of Youth Faith Formation Families (including Students, Parents, Volunteers, and Staff)
Each person in our parish family has the right to:
  • Be treated in a manner that exemplifies Christ’s command to “love one another.”
  • Be treated respectfully by each other.
  • Grow in faith in a caring and positive atmosphere.
  • Receive support when needed.
  • Expect that the parish will provide a strong faith-based curriculum.
  • Work with others who come to class prepared for each lesson.
  • Have every opportunity to excel in a safe environment.
Responsibilities of Youth Faith Formation Families (including Students, Parents, Volunteers, and Staff)
Each person in our parish family has the responsibility to:
  • Treat others in a manner that exemplifies Christ’s command to “love one another.”
  • Show respect to each other by using good manners.
  • Contribute to a caring and positive environment.
  • Seek support in an honest and appropriate manner.
  • Approach each lesson with a willingness to learn and grow in faith.
  • Come to class prepared for each lesson.
  • Volunteers and staff commit to complying with the safe environment requirements of the Diocese of Rockford.
  • Abide, to the best of our abilities, by the Precepts of the Catholic Church (the minimum in prayer and living a moral life):
    • Attend Mass on Sundays and Holy Days of Obligation
    • Confess serious sin at least once a year
    • Receive Holy Communion at least once a year during the Easter season
    • Observe days of fast and abstinence
    • Provide for the needs of the Church
  • Abide by the Youth Faith Formation program expectations and policies (see the Family Handbook posted on our web site).
Student Code of Conduct
Each catechist will discuss with students the specific behavioral expectations for their class. Most misbehavior will be addressed at the classroom level. Catechists will contact parents and RE Office staff if the student’s behavior impacts classroom instruction. If a student’s behavior continues to impact the class, the RE Office staff may choose to meet with student or with the catechists, parents, and student in a dialogue.

Behaviors that negatively impact instruction include, but are not limited to:
  • Disrespectful and rude behavior.
  • Use of foul or inappropriate language.
  • Refusal to comply with instructions from catechists or staff.
  • Being in any parish space or leaving parish grounds without permission.
  • Using cell phones or other electronics in a manner that detracts from the learning or prayer situation.
More serious infractions can result in required meetings between RE Office staff and the Pastor and parents, students, and catechist, or can result in movement from an on-site class to the home study program. These infractions include but are not limited to:
  • Bullying, fighting, threatening or harassing
  • Vandalism of parish property, stealing, smoking, using drugs or alcohol
  • Possession of drugs or alcohol on parish grounds
  • Possession of a weapon on church grounds or at parish sponsored events
Date*:     Parent/Guardian’s Signature (type full name)*:

As parent/guardian, I have reviewed these expectations with my family.*

Tuition and Fees Worksheet
Family Last Name     Date

TuitionCost for 1 StudentCost for 2 StudentsCost for 3+ Students=
for all preschool through 8th grade
students (onsite and home study)		$140$235$300
FeesCostx Student(s)
Material Fee per student
for all preschool through 8th grade students		$25$0.00
Bible Stories Fee per family: Loyola Kids Book of Bible Stories
for all 1st grade through 4th grade students (purchased once and used for three years)		$18$0.00
Bible Fee per student: Breaking Bread Bible
for all 5th grade and older students (purchased once and used for four years)		$25$0.00
Sacramental Fee per student - $30.
for any student celebrating 1st Communion, 1st Reconciliation, and/or Confirmation including all 2nd grade and all 8th grade students		$30$0.00
Youth Group Fee per student
for all high school students		$120$0.00
Late Fee
+$30 late fee if turned in after July 7, 2021		$0.00
Total$0.00
Payment Submitted
Balance Due$0.00
Your registration is not complete until: (1) All paperwork is received, (2) Payment of at least all of
fees is submitted, and (3) All balances from previous years have been paid in full.

If you are unable to pay even the fees at this time, please submit this paperwork, and contact
Therese (tstahl@sjnstcharles.org) or Mark (mrestaino@sjnstcharles.org).


Payment Made Via
Online at www.osvonlinegiving.com/225.
Check made out to St. John Neumann
Cash (The parish cannot make change for cash payments)

Choose One:
I have paid my total due in full: $30.00
I have paid all fees: $30.00, and my remaining balance will be paid by April 1, 2022.
I have paid all fees: $30.00, but my family is experiencing financial hardship. I will fill out the financial aid form
    by September 15, 2021, at: https://online.factsmgt.com/signin/4L4DS.

 

If you submit registration through this web-based form, there is no need to include a printed registration packet if you mail in a check payment or bring in cash. Just make sure that the payment is accompanied by your family last name and children’s names.






2900 E. Main St. St. Charles, IL 60174 (630) 377-2797
 
Copyright © 2019 | St. John Neumann Catholic Church