THIS FORM IS AVAILABLE FOR PRINTING ON THE HOMEPAGE SIDE BAR
Registration: _____ First Communion $30 Class Assigned: ______________ _____ Confirmation $30 Room: ____________
_____ PREP $15
_____ Full Initiation $30
_____ Youth Group No Charge
Student’s Full Name _____________________________________________________________________
Age: _________ Grade in School: ___________
Date of Birth ______________ City/State/Country of Birth _________________________________
Father’s Full Name _______________________________________________________________________
Mother’s Full Name ______________________________________________________________________
(please include your maiden name)
Address: ________________________________________________________________________________
City: _______________________________ State: _____________________ Zip: ___________________
Phone Number: ______________________________ Other Phone: ______________________________
Email: __________________________________________________________________________________
Has your child been baptized? Yes No
Name of Church ___________________________________________ Date ________________________
Address of Church: ______________________________________________________________________
City _______________________________________ State/Country ______________________________
Allergies or Special Needs:
_________________________________________________________________________________________
Emergency Contact: __________________________________ Phone: _____________________________
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Students Name ________________________________________________________
Paid: _________________ Amount: ________________Cash____ Check_____ Date: ______
Registro: _____ First Communion $30 Class Assigned: ______________
_____ Confirmation $30 Room: _____________
_____ PREP $15
_____ Full Initiation $30
_____ Youth Group No Charge
Nombre complete del estudiante __________________________________________________________
Edad____________ Grado in la escuela____________
Feche de nacimiento ________________ Ciudad/Estado/Pais de Nacimiento_____________________
Nombre complete del Padre: _______________________________________________________________
Nombre complete del Madre _______________________________________________________________
(por favor incluya su nombre de soltera)
Direccion: ________________________________________________________________________________
Ciudad: ___________________________________ Estado: _____________________ Postal ___________
Telefono: __________________________________ Otro Telefono: ________________________________
Email: ___________________________________________________________________________________
Su nino ha sido bautizado? _____ Si _____ No
Nombre de la Iglesia: ______________________________________________ Feche: ________________
Dirección de la iglesia: ________________________________________
Ciudad/Estado/Pais de Bautismo: __________________________________________________________
Allergias conocidas o necesidades especiales:
_________________________________________________________________________________________
Contacto de emergencia: ______________________________________ Telefono: ___________________
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Students Name ________________________________________________________
Paid: _________________ Amount: ___________ Cash____ Check_____ Date: