Catholic Church
GENERAL INFORMATION
Student Name:
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Birthdate:
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Father's Name:
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Age:
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Mother's Name:
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Maiden Name:
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Address:
Home Phone:
Email:
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Work Phone:
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Cell Phone:
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Total Students:
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OTHER INFORMATION
Are you a registered member of the Parish?
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School enrolled in:
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Grade:
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Allergies | Medical Conditions:
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Physician:
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Physician Phone:
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In the event that I cannot be reached during a medical emergency, I give permission for any medical treatment deemed necessary and appropriate for my son/daughter.
Home:
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Guardian:
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Cell
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Guardian Cell:
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SACRAMENTS RECEIVED
Baptism:
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Date:
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Church:
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Address:
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First Reconciliation:
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Date:
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Church:
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Date:
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First Communion:
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Date:
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Confirmation:
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Date:
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Church:
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Church:
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Address:
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Address:
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CCD Registration 2025-2026 | St. Mildred Catholic Church