Summer Registration 2025 - Week 2 - St. Mary of Mount Carmel Parish

DATES: Week 2 - Monday, July 28 through Friday, August 1

Are you a member of our Parish? Yes No

Family Last Name Please enter valid data.

Primary Parent/Guardian

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.
Address REQUIRED Please fill out this field. Please enter valid data.
City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.
Phone Number (This will be the main phone number we will use to communicate with your family) REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
Email (This will be the main email address we will use to communicate with your family) REQUIRED Please fill out this field. Please enter an email address.
Marital Status
Maiden Name (if applicable) Please enter valid data.
Religion Please enter valid data.

Secondary Parent/Guardian

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.
Cell Phone REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
Email Please enter an email address.
Marital Status
Religion Please enter valid data.

Payment

Class fee per week REQUIRED 250.0 – 1 child 480.0 – 2 children 710.0 – 3 children Please fill out this field.

Emergency Contact

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.
Relationship Please enter valid data.
Emergency Contact Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
Address Please enter valid data.
City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Would you like to volunteer? YES! So happy you asked! Sorry, I can't this year

Child(ren)s Vaccinations up to date? Yes No

Does your child have any academic difficulties (i.e. speech, hearing or reading, etc.) which could impair his/her progress in religious education classes?

Please list any medications, allergies or other medical conditions

Acknowledgements

I understand that in the case of injury or illness, every effort will be made to contact me in a medical emergency. In the event I cannot be reached, I give permission to parish staff to secure all proper and necessary treatment for my child(ren). I understand that no liability is assumed by the church or the Diocese for claims that may arise.
I Agree Please select this field.
Parental Consent for Medical Care: In case of an emergency, I give permission for my child to receive emergency medical treatment and, if necessary, be transported to the nearest appropriate medical facility.
I Agree Please select this field.
Photo Release: I hereby grant to St. Mary of Mt. Carmel Parish the unqualified authorization to use and display on the St. Mary of Mt. Carmel parish website, social media site, or in other official church printed publications, photographs taken of the child/children listed on this registration participating in church sponsored events. I certify that I am the parent and/or legal guardian of this child/children. Therefore, I agree to indemnify and hold harmless the church, clergy, staff, and volunteers from any claims arising out of the use of these photographs.
I Agree Please select this field.
The Diocese of Camden Mandates that all Faith Formation (Religious Education) Programs teach our students to identify and outsmart the lures that are consistently used in predatory crimes against youngsters both offline and online. Youngsters learn essential personal safety skills to improve self-reliance and raise self esteem while being consistently reassured that most people are kind, safe, and committed to their well being. The program also includes lessons on the Internet safety, and lures of drugs, bullying and school violence prevention. In order for this to proceed we will need parental consent.

I give permission for my child/children to attend the "Teaching Safety Empowering God's Children Program," as mandated by the Diocese of Camden
I Agree Please select this field.
3.1% processing fee. REQUIRED Thank you Please fill out this field.

St. Mary of Mount Carmel Parish

Hammonton, NJ

Summer Registration 2025 - Week 2

Summer Program 2025

Summer Program Registration Week 2