CCD Registration Form 24

Child's Full Name
Date of Birth

MonthDayYear
Grade in School
Have they been Baptized?

YesNo
Have they made their First Reconciliation?

YesNo
Have they received their First Communion?

YesNo
Are they a returning student?

YesNo

A copy of sacramental certificates are required at registration.

CCD Contribution

1 Child - $35

2 Children - $45

3 Children - $55

4+ Children - $70
Does your child(ren) require any special needs in the classroom?*

YesNo
Do you need to make baptismal arrangements for any of the children?*

YesNo
Would you be interested in being a Parent Helper within this program?*

YesNo
Initial*
ParentGuardian Signature*

Clear
Date*

MonthDayYear
Date
Should be Empty: