Worship Schedule

Weekend

Saturday

Confessions
3:00-3:45 PM
Mass
4:00 PM

Sunday

Mass
9:00 AM
11:00 AM

Weekday Masses

7:30 AM

(Check Bulletin for Special Masses)

Anointing Information

By appointment.
Call Parish Office 920-336-1813.

Online Parental/Guardian Permission
and Insurance Release Form

St. Francis Xavier Parish
St. Mary Catholic Church

Religious Formation / Youth Ministry
Transportation-Bus and Field Trip Form (Grades 2-11)

The following student(s) has my permission to participate in youth activities and field trips this year, taking the bus after school from Dickinson, Heritage, Susie C. Altmayer, Foxview and Notre Dame schools to St. Francis Xavier Parish or St. Mary Catholic Church. (Grades 2-11 must complete this form and return.)









Student One



School:

Grade as of September:

Does your child have allergies, special medical or learning needs:

Student Two



School:

Grade as of September:

Does your child have allergies, special medical or learning needs:

Student Three



School:

Grade as of September:

Does your child have allergies, special medical or learning needs:

Hospital and Physician Information



Local Physician's Name:

Physician's Address:

I understand that neither St. Francis / St. Mary nor any of its agents are responsible for any injury sustained by my child. I accept responsibility for any medical expenses as a result of any such injury sustained. In case of accident or serious illness and we are unable to be reached, I hereby authorize St. Francis / St. Mary to call the physician listed above and to follow his instructions. If this physician is unable to be contacted, you may make whatever arrangements are deemed necessary. Submitting this form online indicates permission is granted.

Any pictures taken of my child may be used for church purposes: Bulletin board, website, direct youth promotional flyers, bulletin, etc.

This permission form will be in effect for my child / children during their Religious Formation years and can be withdrawn at any time in writing.

NOTE: If you have more than three children, continue to fill out additional forms until all the children have been registered.