Religious Education/ CCD Registration

Name *

First

Last

Date of Birth *

The grade this child will be in for the 2023-2024 school year *

School your child will be in for the 2023-2024 school year *

Family Name *

Home Phone *

Email *

Fathers Name *

Work or cell phone *

Religion *

Mothers Name *

Work or cell phone *

Religion *

If you are legally responsible for the child, but are not the mother or father: Name

Work or cell phone *

Religion *

Email *

Relationship *

Home phone *

Cell Phone *

List any special Medical conditions/Prescribed Medications that apply to your child *

List restrictions/allergy(i.e. milk, peanut butter) or other information needed to provide a safe environment for your child *

List any learning ability or disability that will help us provide a proper learning environment for your child *

Sacraments your child has received: Date of Baptism *

Church of Baptism *

Date of First Reconciliation *

Date of First Holy Communion *

Date of Confirmation *

Photo Release Permission *

Catechist Transportation Release *