St. Clare Church

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Please fill out the following form. You may also download a PDF for printing, and fill it out for mailing to the office at your convenience (see address above). If you have any questions, please call us at 503-244-1037. Thank you!


Youth Information
Subject of Registration:
Grade:	School:
First Name:	Last:
Age:	Sex: Catholic:
Address:
City:	State: Zip:
Home Phone:
Email:
Date of Birth:	Place:
Baptism Date:	City:State:
Church of Baptism:
Sacraments:	EucharistReconciliation


Parent/Guardian Information
Parents Are:	Youth Lives with:
Father's Name:	Religion:
Archdiocese Background Check:	Date:Place:
Mother's Name:	Religion:
Mother's Maiden Name:
Archdiocese Background Check:	Date:Place:
Guardian's Name:	Religion:
Archdiocese Background Check:	Date:Place:


Student/Youth Emergency Information
Doctor's Name:	Phone:
Medical Insurance Name:	Policy #:
Emergency Contact:	Phone:
Allergies and/or Special Circumstances:

I authorize the Archdiocese of Portland and its representatives to use their judgment in determining emergency care and procedures for my child. I also understand and agree that the Archdiocese assumes no financial obligation for expenses incurred in carrying out emergency procedures and/or emergency transportation. Please check the box to signify your understanding: I have read and accept these terms.
Online Signature:	Date:

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School | Preschool
St. Clare Home

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NEWS & EVENTS

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Please check back soon for news about upcoming St. Clare Parish events!