Blessed Beginnings 2026-2027
Student Information
Student Name
*
First Name
Middle Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Age
*
Gender
*
Please Select
Female
Male
Grade for the 2025-26 School Year
*
Please Select
Pre-K
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
Sixth Grade
Seventh Grade
Eighth Grade
Parent/Guardian Information
Name of Parent/Guardian
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Emergency Information
Emergency Contact
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Relationship to Student
*
Please Select
Mother
Father
Sister
Brother
Grandmother
Grandfather
Aunt
Uncle
Other
If "other", please list relationship
Allergies?
*
If yes, write them here. If no, write "N/A".
Program Questions
Are you a returning student?
*
Yes, I am a returning student.
No, I am new to the program.
If "No", has the student been apart of any other CCD program?
Yes
No
What program are you enrolling in?
Baptism and First Communion Prepartation
Continued Faith Formation
Has the student received any sacrament? (Select all that apply)
*
Baptism
Reconciliation
First Holy Communion
No, the student has not recieved any sacraments
Does the student own a Bible?
*
Yes, the Bible he/she received at the End of the Year Brunch
Yes, a version we have at home.
No
Does the student have a rosary?
*
Yes
No
If you a part of the program last year, is there anything you think we can improve on?
Media Release Form
Please read the consent form below.
Do you agree with the Media Release form?
*
Yes, I do not mind my child being photographed and understand that his/ her photo may be used in social media and/or the Blessed Beginnings website.
No, I would not like my child to be photographed or be used in social media and/or the Blessed Beginnings website.
Student Name
First Name and Last Name
If "Yes", please write your name
First Name and Last Name
Today's Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit
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