CCD Registration FORM

Family Name REQUIRED Please fill out this field. Please enter valid data.

Family Contact Email REQUIRED Please fill out this field. Please enter an email address.

Father's Name Please enter valid data.

Father's Religion Please enter valid data.

Father's Phone Number Please enter a phone number.

Mother's Name Please enter valid data.

Mother's Religion Please enter valid data.

Mother's Phone Number Please enter a phone number.

Parental Status: REQUIRED Please fill out this field.

Mailing Address REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

How many children are you registering? REQUIRED Please fill out this field.
Child 1
- Name REQUIRED Please fill out this field. Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter valid data.
- Grade REQUIRED Please fill out this field. Please enter valid data.
- Baptized? REQUIRED Yes No Please fill out this field.
- First Communion? REQUIRED Yes No Please fill out this field.
Child 2
- Name REQUIRED Please fill out this field. Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter valid data.
- Grade REQUIRED Please fill out this field. Please enter valid data.
- Baptized? REQUIRED Yes No Please fill out this field.
- First Communion? REQUIRED Yes No Please fill out this field.
Child 3
- Name REQUIRED Please fill out this field. Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter valid data.
- Grade REQUIRED Please fill out this field. Please enter valid data.
- Baptized? REQUIRED Yes No Please fill out this field.
- First Communion? REQUIRED Yes No Please fill out this field.
Child 4
- Name REQUIRED Please fill out this field. Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter valid data.
- Grade REQUIRED Please fill out this field. Please enter valid data.
- Baptized? REQUIRED Yes No Please fill out this field.
- First Communion? REQUIRED Yes No Please fill out this field.
Child 5
- Name REQUIRED Please fill out this field. Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter valid data.
- Grade REQUIRED Please fill out this field. Please enter valid data.
- Baptized? REQUIRED Yes No Please fill out this field.
- First Communion? REQUIRED Yes No Please fill out this field.
Child 6
- Name REQUIRED Please fill out this field. Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter valid data.
- Grade REQUIRED Please fill out this field. Please enter valid data.
- Baptized? REQUIRED Yes No Please fill out this field.
- First Communion? REQUIRED Yes No Please fill out this field.
Child 7
- Name REQUIRED Please fill out this field. Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter valid data.
- Grade REQUIRED Please fill out this field. Please enter valid data.
- Baptized? REQUIRED Yes No Please fill out this field.
- First Communion? REQUIRED Yes No Please fill out this field.
Child 8
- Name REQUIRED Please fill out this field. Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter valid data.
- Grade REQUIRED Please fill out this field. Please enter valid data.
- Baptized? REQUIRED Yes No Please fill out this field.
- First Communion? REQUIRED Yes No Please fill out this field.
Child 9
- Name REQUIRED Please fill out this field. Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter valid data.
- Grade REQUIRED Please fill out this field. Please enter valid data.
- Baptized? REQUIRED Yes No Please fill out this field.
- First Communion? REQUIRED Yes No Please fill out this field.
Child 10
- Name REQUIRED Please fill out this field. Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter valid data.
- Grade REQUIRED Please fill out this field. Please enter valid data.
- Baptized? REQUIRED Yes No Please fill out this field.
- First Communion? REQUIRED Yes No Please fill out this field.

Please indicate here if any of your children have medical, physical, mental conditions or allergies of which we should be aware: REQUIRED Please fill out this field.

How many people would you like to put on the pick up list? REQUIRED Please fill out this field.
Person 1
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Phone number REQUIRED Please fill out this field. Please enter valid data.
Person 2
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Phone number REQUIRED Please fill out this field. Please enter valid data.
Person 3
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Phone number REQUIRED Please fill out this field. Please enter valid data.
Person 4
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Phone number REQUIRED Please fill out this field. Please enter valid data.

Will you volunteer to help at one of our events through the year? REQUIRED Yes No Please fill out this field.

Our Lady of the Gulf

Catholic Church, Bay St. Louis, MS

CCD Registration FORM