EmailMe Form - Order of Christian Initiation Adult Registration

Name *

First Middle Last

Maiden Name:

Nickname

Gender *

Primary Phone Number *

### - ### - ####

Email Address *

Date of Birth *

MM / DD / YYYY

Place of Birth *

Occupation *

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Father's Name's *

First Middle Last

Mother's Name *

First Middle Last

Mother's Maiden *

Have you been attending All Saints Catholic Church? *

Yes

No

How long? *

If you are currently affiliated with another parish, please list which parish: *

How long have you been considering becoming Catholic? *

What religion or denomination are you? *

Briefly describe why are you interested in the Catholic faith? *

SACRAMENTAL INFORMATION

Have you ever been baptized? *

Yes

No

Date of Baptism *

MM / DD / YYYY

Place of Baptism? *

***we will need a copy of your Baptism Certificate ONLY if it wasn't at All Saints.

Are you married *

Yes

No

Date of Marriage *

MM / DD / YYYY

Place of Marriage: *

Spouse's Name *

What religion or denomination are they? *

Is this your first Marriage? *

Yes

No

If not, what is the marital status of your other marriage(s)?

Is this your Spouse's first Marriage? *

Yes

No

If not, what is the marital status of his/her other marriage(s)?

Children's Name(s)?

If divorced, have you begun the annulment process in the Catholic Church? *

Yes

No

If the annulment process has begun, what is the status? *

Do you have a practicing Catholic to sponsor you?* *

Yes

No

Sponsor’s Name:

*If you do not have a sponsor, one will be provided.

Have you been Virtus trained in the past 5 years?: *

Yes

No

Have you had a Sterling background check in the past 5 years?: *

Yes

No

MEDIA RELEASE FORM
REF ID#: YP-MEDIA-04302013.14

Our parish, All Saints Catholic Church, uses images, interviews, and videos of our adults, teens, or childen for a variety of internal and external communications. Our forms of internal and external communications include but are not limited to: print, such as newspapers, bulletins, and newsletters; photographs and digital images; film and videos; web posts, web pages, and image carousels; social networking platforms including but not limited to Facebook, Twitter,
and Instagram.

We follow the Archdiocese of Atlanta’s Social Media Policy and Guidelines for the Use of Social Networking Sites with
Minors. Please see this resource for more information.
Please indicate below whether our parish and/or school has permission to circulate interviews, images, and/or videos of your child for all parish and/or school events for one year: *

*

NO, I do not want to be included, nor my image used, in any internal or external communications.

I hereby grant permission for the following parish, All Saints Catholic Church, to use images and interviews of myself, for internal or external communications for one year.

I may be photographed and/or interviewed for The Georgia Bulletin, and other media outlets. I understand content may be reprinted in The Georgia Bulletin or other media for public dissemination, including but not limited to film; video; television; radio; newspapers such as The Atlanta Journal and Constitution; websites and online platforms; and social media networks including but not limited to Facebook, Twitter, and Instagram. I release and relieve the parish and/or school, and the Archdiocese of Atlanta, from any responsibility or liability for any claims arising from the publication or reproduction of any photographs or interview in any news or other media. I waive any and all right to inspect or approve the finished images, video, or printed matter that may be used in conjunction with any image or video, or to approve the eventual use for which it may be applied. I understand that photographs, videos, and/or interviews are being done with the knowledge and approval of the parish and/or school, and that a signed release form is required for every participating individual.

ASSUMPTION OF THE RISK RELATING TO COVID-19
REF ID#: YP-COVID-04302013.14

The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person to person through respiratory droplets when an infected individual cough, sneezes, or speaks. As a result, government agencies at all levels and federal, state, and local health agencies recommend social distancing and have placed limits on the congregation of groups of individuals.

All Saints Catholic Church has put preventative measures in place to reduce the spread of COVID-19; however, the parish cannot guarantee that you or your child(ren) will not become infected with COVID-19. Further, attending activities on the campus of All Saints Catholic Church could increase your risk and that of your children for contracting COVID-19.

While All Saints Catholic Church/youth group will make all reasonable efforts to lower the risk of COVID-19 exposure and spread at the parish, the parish is unable to provide any guarantee that students or their families will not be exposed to or infected by COVID-19.

By enrolling in and attending parish faith formation, you acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that you, and or other family members may be exposed to or infected by COVID-19. It is expected that students and other family members will follow the preventative measures and guidelines implemented by All Saints Catholic Church/youth group including not coming to the parish premises if demonstrating any signs or symptoms of COVID-19.

Signature

Clear

Date Time

MM / DD / YYYY

**SACRAMENTAL INFORMATION **

** MEDIA RELEASE FORM ** REF ID#: YP-MEDIA-04302013.14

** ASSUMPTION OF THE RISK RELATING TO COVID-19 ** REF ID#: YP-COVID-04302013.14

SACRAMENTAL INFORMATION

MEDIA RELEASE FORM
REF ID#: YP-MEDIA-04302013.14

ASSUMPTION OF THE RISK RELATING TO COVID-19
REF ID#: YP-COVID-04302013.14