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Church of the Resurrection
4300 Asbury Road, Dubuque, IA 52002
(563) 556-7511
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Home
Our Parish
NEWS
Christ Our Life Conference
WHOLE PARISH EVENTS
Journey in Faith
Parish Information
Calendar
Parish Registration
Contact Us
Parish Committees
Funeral Planning
Parish Information
Communications
Bulletins
Catholic Dubuque
The Archdiocese of Dubuque
TOGETHER Archdiocese Monthly Parish Bulletin
Holy Family School System
Support
PRAY, SHARE AND GIVE
Stewardship
SCRIP
Ministries
Liturgy & Prayer
Join Us for Mass
Mass Times
Adoration
Week Day Mass Weather Policy
Ministries
Liturgical Ministries
Children's Liturgy of the Word
Faith Formation & Sacraments
Adult Faith Formation
Becoming Catholic (OCIA)
Faith Enrichment Opportunities
Young Adult Ministry
Adult Confirmation
Youth Faith Formation
Pre K-12 Faith Formation
Youth Ministry
Vacation Bible School
Sacramental Preparation
Baptism
First Reconciliation & Eucharist
Confirmation
Marriage
Confirmation Registration 2027
Faith Formation & Sacraments
Adult Faith Formation
Becoming Catholic (OCIA)
Faith Enrichment Opportunities
Young Adult Ministry
Adult Confirmation
Youth Faith Formation
Pre K-12 Faith Formation
Youth Ministry
Vacation Bible School
Sacramental Preparation
Baptism
First Reconciliation & Eucharist
Confirmation
Confirmation Registration 2027
Marriage
The maximum number of form submissions has been reached. This form is currently not available.
FAMILY INFORMATION
Mother's Full Name: First Middle Last (Maiden)
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Mother's Phone Number
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Father's Phone Number
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Legal Guardian Name and Number
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Registered Parish
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Email
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CHILD #1 INFORMATION
First Name
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Last Name
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Middle Name
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Student Grade in Fall
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9th Grade
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School Attending in Fall
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East Dubuque
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Faith Formation Prior to Sacrament (last school year)
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Holy Family: Mazzuchelli/Wahlert
Parish Program: RE or YFF
Other (explain below)
None
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Your Choice of Class Time:
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Wednesdays at 3:45 PM - 5:00 PM
Wednesdays at 6:30 PM - 7:45 PM
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MEDIA RELEASE AND AUTHORIZATION
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I understand that by responding "Yes" I hereby grant authority to my child’s parish for the use of any videos, photos, or similar items to used in social media or on a parish web page.
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NO
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PARTICIPANT INFORMATION RELEASE
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I understand that by responding "Yes" I hereby grant authority to my child’s parish for the publication of participant information in the parish directory and other parish publications.
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CHILD #2 INFO (if no child #2, leave section blank)
First Name
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Middle Name
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Student Grade in Fall
None
9th Grade
10th Grade
11th Grade
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School Attending in Fall
None
East Dubuque
Hempstead
Homeschool
Senior
Wahlert
Western Dubuque
Other
Faith Formation Prior to Sacrament (last school year)
Holy Family: Mazzuchelli/Wahlert
Parish Program: RE or YFF
Other (explain below)
None
If you chose "other", please explain below.
Please enter valid data.
Your Choice of Class Time:
Wednesdays at 3:45 PM - 5:00 PM
Wednesdays at 6:30 PM - 7:45 PM
MEDIA RELEASE AND AUTHORIZATION
I understand that by responding "Yes" I hereby grant authority to my child’s parish for the use of any videos, photos, or similar items to used in social media or on a parish web page.
YES
NO
PARTICIPANT INFORMATION RELEASE
I understand that by responding "Yes" I hereby grant authority to my child’s parish for the publication of participant information in the parish directory and other parish publications.
YES
NO
ELECTRONIC SIGNATURE
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NO, I am unwilling to sign this form electronically. I understand that I must contact the parish office for a hard copy of the above permissions before my child can participate in the program.
YES, I am the parent or guardian of the child(ren) named above and have the legal authority to execute the above permission(s). I consent to signing this document electronically by typing my name and checking "yes" here.
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First Name
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