CCD Registration

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CCD Registration

Questions? Call the Church Office, at (318) 445-3693 for more information.

Student Information

Name *

First

Last

Preferred Name *

Gender *

Male
Female

T-Shirt Size

Address

Address Line 1

Address Line 2

City

State

Zip Code

School Attending *

Current Grade Level *

Date of Birth *

Baptism *

Baptized
Not Baptized

Baptism Date

If applicable, please add your child's date of baptism.

Name / Location of Church *

Last CCD school attended *

Last Year of CCD Attendance *

Allergies *

Please provide a list of allergies that your child has (if any).

Fun Facts *

Please provide any information about your child that would be helpful for our CCD teachers.

Parental Information

Father's Name *

First

Last

Religion *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Cell Phone Number *

Work Number *

Email *

Mother's Name *

First

Last

Religion *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Cell Phone Number *

Work Number *

Email *

Church Parish *

Church Parish where you are registered or attend Mass regularly

Emergency Contact *

Please provide name and phone number for an emergency contact other than Parent(s)

Photo Permissions *

Registration Fee *

Price: $30.00

Captcha *

CCD Registration