YouTube Facebook Instagram Flocknote

- Faith Formation

Our Junior High Faith Formation Program is offered for those students in grades 6-8. It is open to those who have received their First Holy Communion but are not yet of age to begin their Confirmation preparations and for those preparing for First Communion. Sacrament preparation may include some additional formation sessions.

Each paid registration includes a Catholic Youth Bible and will use the BREAK THROUGH curricullum from St. Mary's Press. BREAK THROUGH is the perfect tool to help middle schoolers to a deeper understanding of Scripture with fun and practical ideas to enhance youth engagement..

PLEASE NOTE: Because of public health concerns surrounding the COVID-19 pandemic, and in our effort to stay in compliance with state, local, and archdiocesan guidelines, we will gather in person following all guidelines. In the event that we cannot meet in person, formation will continue with virtual meetings via ZOOM. Some formation will continue in your homes as we will provide you with all needed supplies and support.
Contact
- Ruben Castorena
  
  Director of Religious Education, Confirmation, & Youth Ministry
  
  (818) 731-7389
  confirmyouthincaglendale.org
2021-2022 Registration For Junior High
The maximum number of form submissions has been reached. This form is currently not available.
- Do you or your child have access to an internet connection? REQUIRED Yes No Please fill out this field.
- Do you or your child have access to a digital device to access our faith formation resources? REQUIRED Yes No Please fill out this field.
- Mother (as listed on Baptismal Certificate)
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Maiden Name REQUIRED Please fill out this field. Please enter valid data.
  
  Street Address REQUIRED Please fill out this field. Please enter valid data.
  
  Apt., Ste., Bldg. 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.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Mobile Phone REQUIRED Please fill out this field. Please enter a phone number.
  
  Home Phone REQUIRED Please fill out this field. Please enter a phone number.
  
  Work Phone Please enter a phone number.
- Father (as listed on Baptismal Certificate)
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Street Address REQUIRED Please fill out this field. Please enter valid data.
  
  Apt., Ste., Bldg. 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.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Mobile Phone REQUIRED Please fill out this field. Please enter a phone number.
  
  Home Phone REQUIRED Please fill out this field. Please enter a phone number.
  
  Work Phone Please enter a phone number.
- Total Number of Children to be Registered REQUIRED Please fill out this field.
  
  Child 1
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  My child has received the following sacraments REQUIRED Baptism First Communion Confirmation Please fill out this field.
  
  School REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field.
  
  I have the following documents: REQUIRED Certificate of Baptism Certificate of Birth Certificate of First Communion Please fill out this field.
  
  What was the last year of Religious Education your child has attended? REQUIRED Please fill out this field.
  
  Living Arrangements REQUIRED Please fill out this field.
  
  Are there any custody issues or restraining orders in place related to your child? REQUIRED No Yes Please fill out this field.
  
  Given the nature of the program, does your child or youth have any physical, mental, emotional, cognitive, or other limitations or restrictions that would require the parish to make a minor adjustment to enable your child or youth to participate? REQUIRED No Yes Please fill out this field.
  
  If yes, what type of restriction does your child or youth have or what adjustment(s) will be needed?
  
  Permission and Medical Release
  I request that my child be permitted to participate in the above activity. I am not aware of any physical or medical condition my child has that would prevent my child from participating fully in this activity. If my child needs to take medication while participating in this activity, I hereby give my child permission to self-administer his/her medication in accordance with the Medication Authorization and Permission Form, and, if my child cannot self-administer, I give permission to the responsible staff members or chaperones to administer or to assist in the administration of my child’s medication. I also give permission to the responsible staff members, chaperones, medical practitioners and medical facilities to use their judgement in obtaining and providing medical treatment for my child should it become necessary to do so. I understand that health insurance benefits through the Location, if any, may have limited application, and that I am entirely responsible for the cost of all medical treatment provided to my child. I agree to reimburse the Location for the cost of any medical treatment and related expense incurred.
  
  Release of Liability
  As a condition of participating in this activity, I hereby hold harmless, release and discharge The Roman Catholic Archbishop of Los Angeles, a corporation sole, Archdiocese of Los Angeles Education & Welfare Corporation and the Location, their respective agents and employees and any parent/volunteer/chaperone, from any and all liability, loss or claims for personal injuries, wrongful death or property damage that I or my child may suffer as a result of participation in the activity described above.
  
  My son/daughter has the following medical needs, allergies, or dietary restrictions:
  
  Medical Release: REQUIRED By checking the box, I, the parent/guardian of above named child/children, agree to the above medical treatment statement. Please fill out this field.
  
  Media Release
  I understand and agree that my child’s image, voice, name and/or work (“Personal Information”) relating to the events or activities described in this program/process above will be used for noncommercial purposes, including, but not limited to, publicity, exhibits, electronic media broadcasts or research. I understand and agree that my child’s Personal Information may be copied, edited and distributed by the Location in publications, catalogues, brochures, books, yearbooks, magazines, exhibits, films, videotapes, CDs, DVDs, email messages, websites, or any other form now known or later developed (“Materials”). The Location may use the Personal Information at its sole discretion, with or without my child’s name or with a fictitious name, and with accurate or fictitious biographical material. Incarnation Church will not use the Personal Information for improper purposes or in a manner inconsistent with the teachings of the Roman Catholic Church. I waive any right to inspect or approve any Materials that may be created using the Personal Information now and in the future. In exchange for the opportunity given to my child by the Incarnation Church to participate in the activity, I agree that neither I, nor my child, will receive monetary compensation, royalties or credit. I understand and agree that the Incarnation Church shall be the owner of all right, title and interest, including copyright, in the photographs, electronic recordings and Materials. If Incarnation Church intends to use the Materials for a commercial purpose, I will be provided at that time with information about the terms of the commercial use.
  
  Release of Liability
  I hereby waive, release and forever discharge any and all claims, demands, or causes of action against the Incarnation Church and its affiliated entities, employees, agents, contractors and any other person, organization, or entity assisting them with the photography, electronic recording or Materials, for damages or injuries in any way related to, or arising from the photography, electronic recording or Materials, or the use of the Personal Information, and I expressly assume the risk of any resulting injury or damage. I further understand and agree that this Authorization remains in effect until it is withdrawn in writing. I understand that if I change my mind about this Authorization, that I will submit another, new authorization form to the Incarnation Church. However, my new authorization will not have the effect of revoking this Authorization, and the Location will have no duty or obligation to make any changes or alterations to any Materials that may have been prepared based on this Authorization. I represent that I have read this Authorization, understand the contents and am able to grant the rights and waivers it contains. I understand that the terms of this Authorization are contractual and not mere recitals. I am signing this document freely and voluntarily.
  
  Media Release: REQUIRED By checking the box, I, the parent/guardian of above named child/children agree to the above media release statement. Please fill out this field.
  
  Child 2
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  My child has received the following sacraments REQUIRED Baptism First Communion Confirmation Please fill out this field.
  
  School REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field.
  
  I have the following documents: REQUIRED Certificate of Baptism Certificate of Birth Certificate of First Communion Please fill out this field.
  
  What was the last year of Religious Education your child has attended? REQUIRED Please fill out this field.
  
  Living Arrangements REQUIRED Please fill out this field.
  
  Are there any custody issues or restraining orders in place related to your child? REQUIRED No Yes Please fill out this field.
  
  Given the nature of the program, does your child or youth have any physical, mental, emotional, cognitive, or other limitations or restrictions that would require the parish to make a minor adjustment to enable your child or youth to participate? REQUIRED No Yes Please fill out this field.
  
  If yes, what type of restriction does your child or youth have or what adjustment(s) will be needed?
  
  Permission and Medical Release
  I request that my child be permitted to participate in the above activity. I am not aware of any physical or medical condition my child has that would prevent my child from participating fully in this activity. If my child needs to take medication while participating in this activity, I hereby give my child permission to self-administer his/her medication in accordance with the Medication Authorization and Permission Form, and, if my child cannot self-administer, I give permission to the responsible staff members or chaperones to administer or to assist in the administration of my child’s medication. I also give permission to the responsible staff members, chaperones, medical practitioners and medical facilities to use their judgement in obtaining and providing medical treatment for my child should it become necessary to do so. I understand that health insurance benefits through the Location, if any, may have limited application, and that I am entirely responsible for the cost of all medical treatment provided to my child. I agree to reimburse the Location for the cost of any medical treatment and related expense incurred.
  
  Release of Liability
  As a condition of participating in this activity, I hereby hold harmless, release and discharge The Roman Catholic Archbishop of Los Angeles, a corporation sole, Archdiocese of Los Angeles Education & Welfare Corporation and the Location, their respective agents and employees and any parent/volunteer/chaperone, from any and all liability, loss or claims for personal injuries, wrongful death or property damage that I or my child may suffer as a result of participation in the activity described above.
  
  My son/daughter has the following medical needs, allergies, or dietary restrictions:
  
  Medical Release: REQUIRED By checking the box, I, the parent/guardian of above named child/children, agree to the above medical treatment statement. Please fill out this field.
  
  Media Release
  I understand and agree that my child’s image, voice, name and/or work (“Personal Information”) relating to the events or activities described in this program/process above will be used for noncommercial purposes, including, but not limited to, publicity, exhibits, electronic media broadcasts or research. I understand and agree that my child’s Personal Information may be copied, edited and distributed by the Location in publications, catalogues, brochures, books, yearbooks, magazines, exhibits, films, videotapes, CDs, DVDs, email messages, websites, or any other form now known or later developed (“Materials”). The Location may use the Personal Information at its sole discretion, with or without my child’s name or with a fictitious name, and with accurate or fictitious biographical material. Incarnation Church will not use the Personal Information for improper purposes or in a manner inconsistent with the teachings of the Roman Catholic Church. I waive any right to inspect or approve any Materials that may be created using the Personal Information now and in the future. In exchange for the opportunity given to my child by the Incarnation Church to participate in the activity, I agree that neither I, nor my child, will receive monetary compensation, royalties or credit. I understand and agree that the Incarnation Church shall be the owner of all right, title and interest, including copyright, in the photographs, electronic recordings and Materials. If Incarnation Church intends to use the Materials for a commercial purpose, I will be provided at that time with information about the terms of the commercial use.
  
  Release of Liability
  I hereby waive, release and forever discharge any and all claims, demands, or causes of action against the Incarnation Church and its affiliated entities, employees, agents, contractors and any other person, organization, or entity assisting them with the photography, electronic recording or Materials, for damages or injuries in any way related to, or arising from the photography, electronic recording or Materials, or the use of the Personal Information, and I expressly assume the risk of any resulting injury or damage. I further understand and agree that this Authorization remains in effect until it is withdrawn in writing. I understand that if I change my mind about this Authorization, that I will submit another, new authorization form to the Incarnation Church. However, my new authorization will not have the effect of revoking this Authorization, and the Location will have no duty or obligation to make any changes or alterations to any Materials that may have been prepared based on this Authorization. I represent that I have read this Authorization, understand the contents and am able to grant the rights and waivers it contains. I understand that the terms of this Authorization are contractual and not mere recitals. I am signing this document freely and voluntarily.
  
  Media Release: REQUIRED By checking the box, I, the parent/guardian of above named child/children agree to the above media release statement. Please fill out this field.
  
  Child 3
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  My child has received the following sacraments REQUIRED Baptism First Communion Confirmation Please fill out this field.
  
  School REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field.
  
  I have the following documents: REQUIRED Certificate of Baptism Certificate of Birth Certificate of First Communion Please fill out this field.
  
  What was the last year of Religious Education your child has attended? REQUIRED Please fill out this field.
  
  Living Arrangements REQUIRED Please fill out this field.
  
  Are there any custody issues or restraining orders in place related to your child? REQUIRED No Yes Please fill out this field.
  
  Given the nature of the program, does your child or youth have any physical, mental, emotional, cognitive, or other limitations or restrictions that would require the parish to make a minor adjustment to enable your child or youth to participate? REQUIRED No Yes Please fill out this field.
  
  If yes, what type of restriction does your child or youth have or what adjustment(s) will be needed?
  
  Permission and Medical Release
  I request that my child be permitted to participate in the above activity. I am not aware of any physical or medical condition my child has that would prevent my child from participating fully in this activity. If my child needs to take medication while participating in this activity, I hereby give my child permission to self-administer his/her medication in accordance with the Medication Authorization and Permission Form, and, if my child cannot self-administer, I give permission to the responsible staff members or chaperones to administer or to assist in the administration of my child’s medication. I also give permission to the responsible staff members, chaperones, medical practitioners and medical facilities to use their judgement in obtaining and providing medical treatment for my child should it become necessary to do so. I understand that health insurance benefits through the Location, if any, may have limited application, and that I am entirely responsible for the cost of all medical treatment provided to my child. I agree to reimburse the Location for the cost of any medical treatment and related expense incurred.
  
  Release of Liability
  As a condition of participating in this activity, I hereby hold harmless, release and discharge The Roman Catholic Archbishop of Los Angeles, a corporation sole, Archdiocese of Los Angeles Education & Welfare Corporation and the Location, their respective agents and employees and any parent/volunteer/chaperone, from any and all liability, loss or claims for personal injuries, wrongful death or property damage that I or my child may suffer as a result of participation in the activity described above.
  
  My son/daughter has the following medical needs, allergies, or dietary restrictions:
  
  Medical Release: REQUIRED By checking the box, I, the parent/guardian of above named child/children, agree to the above medical treatment statement. Please fill out this field.
  
  Media Release
  I understand and agree that my child’s image, voice, name and/or work (“Personal Information”) relating to the events or activities described in this program/process above will be used for noncommercial purposes, including, but not limited to, publicity, exhibits, electronic media broadcasts or research. I understand and agree that my child’s Personal Information may be copied, edited and distributed by the Location in publications, catalogues, brochures, books, yearbooks, magazines, exhibits, films, videotapes, CDs, DVDs, email messages, websites, or any other form now known or later developed (“Materials”). The Location may use the Personal Information at its sole discretion, with or without my child’s name or with a fictitious name, and with accurate or fictitious biographical material. Incarnation Church will not use the Personal Information for improper purposes or in a manner inconsistent with the teachings of the Roman Catholic Church. I waive any right to inspect or approve any Materials that may be created using the Personal Information now and in the future. In exchange for the opportunity given to my child by the Incarnation Church to participate in the activity, I agree that neither I, nor my child, will receive monetary compensation, royalties or credit. I understand and agree that the Incarnation Church shall be the owner of all right, title and interest, including copyright, in the photographs, electronic recordings and Materials. If Incarnation Church intends to use the Materials for a commercial purpose, I will be provided at that time with information about the terms of the commercial use.
  
  Release of Liability
  I hereby waive, release and forever discharge any and all claims, demands, or causes of action against the Incarnation Church and its affiliated entities, employees, agents, contractors and any other person, organization, or entity assisting them with the photography, electronic recording or Materials, for damages or injuries in any way related to, or arising from the photography, electronic recording or Materials, or the use of the Personal Information, and I expressly assume the risk of any resulting injury or damage. I further understand and agree that this Authorization remains in effect until it is withdrawn in writing. I understand that if I change my mind about this Authorization, that I will submit another, new authorization form to the Incarnation Church. However, my new authorization will not have the effect of revoking this Authorization, and the Location will have no duty or obligation to make any changes or alterations to any Materials that may have been prepared based on this Authorization. I represent that I have read this Authorization, understand the contents and am able to grant the rights and waivers it contains. I understand that the terms of this Authorization are contractual and not mere recitals. I am signing this document freely and voluntarily.
  
  Media Release: REQUIRED By checking the box, I, the parent/guardian of above named child/children agree to the above media release statement. Please fill out this field.
  
  Child 4
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  My child has received the following sacraments REQUIRED Baptism First Communion Confirmation Please fill out this field.
  
  School REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field.
  
  I have the following documents: REQUIRED Certificate of Baptism Certificate of Birth Certificate of First Communion Please fill out this field.
  
  What was the last year of Religious Education your child has attended? REQUIRED Please fill out this field.
  
  Living Arrangements REQUIRED Please fill out this field.
  
  Are there any custody issues or restraining orders in place related to your child? REQUIRED No Yes Please fill out this field.
  
  Given the nature of the program, does your child or youth have any physical, mental, emotional, cognitive, or other limitations or restrictions that would require the parish to make a minor adjustment to enable your child or youth to participate? REQUIRED No Yes Please fill out this field.
  
  If yes, what type of restriction does your child or youth have or what adjustment(s) will be needed?
  
  Permission and Medical Release
  I request that my child be permitted to participate in the above activity. I am not aware of any physical or medical condition my child has that would prevent my child from participating fully in this activity. If my child needs to take medication while participating in this activity, I hereby give my child permission to self-administer his/her medication in accordance with the Medication Authorization and Permission Form, and, if my child cannot self-administer, I give permission to the responsible staff members or chaperones to administer or to assist in the administration of my child’s medication. I also give permission to the responsible staff members, chaperones, medical practitioners and medical facilities to use their judgement in obtaining and providing medical treatment for my child should it become necessary to do so. I understand that health insurance benefits through the Location, if any, may have limited application, and that I am entirely responsible for the cost of all medical treatment provided to my child. I agree to reimburse the Location for the cost of any medical treatment and related expense incurred.
  
  Release of Liability
  As a condition of participating in this activity, I hereby hold harmless, release and discharge The Roman Catholic Archbishop of Los Angeles, a corporation sole, Archdiocese of Los Angeles Education & Welfare Corporation and the Location, their respective agents and employees and any parent/volunteer/chaperone, from any and all liability, loss or claims for personal injuries, wrongful death or property damage that I or my child may suffer as a result of participation in the activity described above.
  
  My son/daughter has the following medical needs, allergies, or dietary restrictions:
  
  Medical Release: REQUIRED By checking the box, I, the parent/guardian of above named child/children, agree to the above medical treatment statement. Please fill out this field.
  
  Media Release
  I understand and agree that my child’s image, voice, name and/or work (“Personal Information”) relating to the events or activities described in this program/process above will be used for noncommercial purposes, including, but not limited to, publicity, exhibits, electronic media broadcasts or research. I understand and agree that my child’s Personal Information may be copied, edited and distributed by the Location in publications, catalogues, brochures, books, yearbooks, magazines, exhibits, films, videotapes, CDs, DVDs, email messages, websites, or any other form now known or later developed (“Materials”). The Location may use the Personal Information at its sole discretion, with or without my child’s name or with a fictitious name, and with accurate or fictitious biographical material. Incarnation Church will not use the Personal Information for improper purposes or in a manner inconsistent with the teachings of the Roman Catholic Church. I waive any right to inspect or approve any Materials that may be created using the Personal Information now and in the future. In exchange for the opportunity given to my child by the Incarnation Church to participate in the activity, I agree that neither I, nor my child, will receive monetary compensation, royalties or credit. I understand and agree that the Incarnation Church shall be the owner of all right, title and interest, including copyright, in the photographs, electronic recordings and Materials. If Incarnation Church intends to use the Materials for a commercial purpose, I will be provided at that time with information about the terms of the commercial use.
  
  Release of Liability
  I hereby waive, release and forever discharge any and all claims, demands, or causes of action against the Incarnation Church and its affiliated entities, employees, agents, contractors and any other person, organization, or entity assisting them with the photography, electronic recording or Materials, for damages or injuries in any way related to, or arising from the photography, electronic recording or Materials, or the use of the Personal Information, and I expressly assume the risk of any resulting injury or damage. I further understand and agree that this Authorization remains in effect until it is withdrawn in writing. I understand that if I change my mind about this Authorization, that I will submit another, new authorization form to the Incarnation Church. However, my new authorization will not have the effect of revoking this Authorization, and the Location will have no duty or obligation to make any changes or alterations to any Materials that may have been prepared based on this Authorization. I represent that I have read this Authorization, understand the contents and am able to grant the rights and waivers it contains. I understand that the terms of this Authorization are contractual and not mere recitals. I am signing this document freely and voluntarily.
  
  Media Release: REQUIRED By checking the box, I, the parent/guardian of above named child/children agree to the above media release statement. Please fill out this field.
  
  Child 5
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  My child has received the following sacraments REQUIRED Baptism First Communion Confirmation Please fill out this field.
  
  School REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field.
  
  I have the following documents: REQUIRED Certificate of Baptism Certificate of Birth Certificate of First Communion Please fill out this field.
  
  What was the last year of Religious Education your child has attended? REQUIRED Please fill out this field.
  
  Living Arrangements REQUIRED Please fill out this field.
  
  Are there any custody issues or restraining orders in place related to your child? REQUIRED No Yes Please fill out this field.
  
  Given the nature of the program, does your child or youth have any physical, mental, emotional, cognitive, or other limitations or restrictions that would require the parish to make a minor adjustment to enable your child or youth to participate? REQUIRED No Yes Please fill out this field.
  
  If yes, what type of restriction does your child or youth have or what adjustment(s) will be needed?
  
  Permission and Medical Release
  I request that my child be permitted to participate in the above activity. I am not aware of any physical or medical condition my child has that would prevent my child from participating fully in this activity. If my child needs to take medication while participating in this activity, I hereby give my child permission to self-administer his/her medication in accordance with the Medication Authorization and Permission Form, and, if my child cannot self-administer, I give permission to the responsible staff members or chaperones to administer or to assist in the administration of my child’s medication. I also give permission to the responsible staff members, chaperones, medical practitioners and medical facilities to use their judgement in obtaining and providing medical treatment for my child should it become necessary to do so. I understand that health insurance benefits through the Location, if any, may have limited application, and that I am entirely responsible for the cost of all medical treatment provided to my child. I agree to reimburse the Location for the cost of any medical treatment and related expense incurred.
  
  Release of Liability
  As a condition of participating in this activity, I hereby hold harmless, release and discharge The Roman Catholic Archbishop of Los Angeles, a corporation sole, Archdiocese of Los Angeles Education & Welfare Corporation and the Location, their respective agents and employees and any parent/volunteer/chaperone, from any and all liability, loss or claims for personal injuries, wrongful death or property damage that I or my child may suffer as a result of participation in the activity described above.
  
  My son/daughter has the following medical needs, allergies, or dietary restrictions:
  
  Medical Release: REQUIRED By checking the box, I, the parent/guardian of above named child/children, agree to the above medical treatment statement. Please fill out this field.
  
  Media Release
  I understand and agree that my child’s image, voice, name and/or work (“Personal Information”) relating to the events or activities described in this program/process above will be used for noncommercial purposes, including, but not limited to, publicity, exhibits, electronic media broadcasts or research. I understand and agree that my child’s Personal Information may be copied, edited and distributed by the Location in publications, catalogues, brochures, books, yearbooks, magazines, exhibits, films, videotapes, CDs, DVDs, email messages, websites, or any other form now known or later developed (“Materials”). The Location may use the Personal Information at its sole discretion, with or without my child’s name or with a fictitious name, and with accurate or fictitious biographical material. Incarnation Church will not use the Personal Information for improper purposes or in a manner inconsistent with the teachings of the Roman Catholic Church. I waive any right to inspect or approve any Materials that may be created using the Personal Information now and in the future. In exchange for the opportunity given to my child by the Incarnation Church to participate in the activity, I agree that neither I, nor my child, will receive monetary compensation, royalties or credit. I understand and agree that the Incarnation Church shall be the owner of all right, title and interest, including copyright, in the photographs, electronic recordings and Materials. If Incarnation Church intends to use the Materials for a commercial purpose, I will be provided at that time with information about the terms of the commercial use.
  
  Release of Liability
  I hereby waive, release and forever discharge any and all claims, demands, or causes of action against the Incarnation Church and its affiliated entities, employees, agents, contractors and any other person, organization, or entity assisting them with the photography, electronic recording or Materials, for damages or injuries in any way related to, or arising from the photography, electronic recording or Materials, or the use of the Personal Information, and I expressly assume the risk of any resulting injury or damage. I further understand and agree that this Authorization remains in effect until it is withdrawn in writing. I understand that if I change my mind about this Authorization, that I will submit another, new authorization form to the Incarnation Church. However, my new authorization will not have the effect of revoking this Authorization, and the Location will have no duty or obligation to make any changes or alterations to any Materials that may have been prepared based on this Authorization. I represent that I have read this Authorization, understand the contents and am able to grant the rights and waivers it contains. I understand that the terms of this Authorization are contractual and not mere recitals. I am signing this document freely and voluntarily.
  
  Media Release: REQUIRED By checking the box, I, the parent/guardian of above named child/children agree to the above media release statement. Please fill out this field.
  
  Child 6
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  My child has received the following sacraments REQUIRED Baptism First Communion Confirmation Please fill out this field.
  
  School REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field.
  
  I have the following documents: REQUIRED Certificate of Baptism Certificate of Birth Certificate of First Communion Please fill out this field.
  
  What was the last year of Religious Education your child has attended? REQUIRED Please fill out this field.
  
  Living Arrangements REQUIRED Please fill out this field.
  
  Are there any custody issues or restraining orders in place related to your child? REQUIRED No Yes Please fill out this field.
  
  Given the nature of the program, does your child or youth have any physical, mental, emotional, cognitive, or other limitations or restrictions that would require the parish to make a minor adjustment to enable your child or youth to participate? REQUIRED No Yes Please fill out this field.
  
  If yes, what type of restriction does your child or youth have or what adjustment(s) will be needed?
  
  Permission and Medical Release
  I request that my child be permitted to participate in the above activity. I am not aware of any physical or medical condition my child has that would prevent my child from participating fully in this activity. If my child needs to take medication while participating in this activity, I hereby give my child permission to self-administer his/her medication in accordance with the Medication Authorization and Permission Form, and, if my child cannot self-administer, I give permission to the responsible staff members or chaperones to administer or to assist in the administration of my child’s medication. I also give permission to the responsible staff members, chaperones, medical practitioners and medical facilities to use their judgement in obtaining and providing medical treatment for my child should it become necessary to do so. I understand that health insurance benefits through the Location, if any, may have limited application, and that I am entirely responsible for the cost of all medical treatment provided to my child. I agree to reimburse the Location for the cost of any medical treatment and related expense incurred.
  
  Release of Liability
  As a condition of participating in this activity, I hereby hold harmless, release and discharge The Roman Catholic Archbishop of Los Angeles, a corporation sole, Archdiocese of Los Angeles Education & Welfare Corporation and the Location, their respective agents and employees and any parent/volunteer/chaperone, from any and all liability, loss or claims for personal injuries, wrongful death or property damage that I or my child may suffer as a result of participation in the activity described above.
  
  My son/daughter has the following medical needs, allergies, or dietary restrictions:
  
  Medical Release: REQUIRED By checking the box, I, the parent/guardian of above named child/children, agree to the above medical treatment statement. Please fill out this field.
  
  Media Release
  I understand and agree that my child’s image, voice, name and/or work (“Personal Information”) relating to the events or activities described in this program/process above will be used for noncommercial purposes, including, but not limited to, publicity, exhibits, electronic media broadcasts or research. I understand and agree that my child’s Personal Information may be copied, edited and distributed by the Location in publications, catalogues, brochures, books, yearbooks, magazines, exhibits, films, videotapes, CDs, DVDs, email messages, websites, or any other form now known or later developed (“Materials”). The Location may use the Personal Information at its sole discretion, with or without my child’s name or with a fictitious name, and with accurate or fictitious biographical material. Incarnation Church will not use the Personal Information for improper purposes or in a manner inconsistent with the teachings of the Roman Catholic Church. I waive any right to inspect or approve any Materials that may be created using the Personal Information now and in the future. In exchange for the opportunity given to my child by the Incarnation Church to participate in the activity, I agree that neither I, nor my child, will receive monetary compensation, royalties or credit. I understand and agree that the Incarnation Church shall be the owner of all right, title and interest, including copyright, in the photographs, electronic recordings and Materials. If Incarnation Church intends to use the Materials for a commercial purpose, I will be provided at that time with information about the terms of the commercial use.
  
  Release of Liability
  I hereby waive, release and forever discharge any and all claims, demands, or causes of action against the Incarnation Church and its affiliated entities, employees, agents, contractors and any other person, organization, or entity assisting them with the photography, electronic recording or Materials, for damages or injuries in any way related to, or arising from the photography, electronic recording or Materials, or the use of the Personal Information, and I expressly assume the risk of any resulting injury or damage. I further understand and agree that this Authorization remains in effect until it is withdrawn in writing. I understand that if I change my mind about this Authorization, that I will submit another, new authorization form to the Incarnation Church. However, my new authorization will not have the effect of revoking this Authorization, and the Location will have no duty or obligation to make any changes or alterations to any Materials that may have been prepared based on this Authorization. I represent that I have read this Authorization, understand the contents and am able to grant the rights and waivers it contains. I understand that the terms of this Authorization are contractual and not mere recitals. I am signing this document freely and voluntarily.
  
  Media Release: REQUIRED By checking the box, I, the parent/guardian of above named child/children agree to the above media release statement. Please fill out this field.
- Program Fees REQUIRED 100.0 – Break-through (Grades 6-8) 25.0 – Additional child discount. Please select this field when enrolling your 2nd, 3rd, ... children. Please fill out this field.
- Thank you for completing your 2021-2022 Religious Ed registration online! Please select one of the payment options below to submit your registration.
Total:

Submit

Pay Now

Pay Later

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Incarnation Catholic Church

1001 N Brand Boulevard, Glendale, CA 91202

Contact

2021-2022 Registration For Junior High