(RCIA) RITE OF CHRISTIAN INITIATION SACRAMENTS OF BAPTISM AND EUCHARIST FOR CHILDREN
AGES of 7 to 13
Birth Certificate needed
Name
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Place
Certificate
Yes
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Father's Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Mother's Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Language Spoken
Name of School
Grade in September
CONSENT
Photograph/Video Release Consent - please check one box and print your name and sign below
I consent to have photographs and /or video taken of my child (ren ) for use b y Our Lady of the Assumption Parish . I understand that any photographs /video would be used solely to illustrate activities that take place at Our Lady of the Assumption
I do NOT give my permission to have my son(s)/daughter(s) photographed or videotaped.
Parent/Guardian printed name:
Signature
Clear
The fee for a child to take this class is $40.
Submit
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