CCD Registration Form

Location

United States

See map: Google Maps

Student Information

Full Name *

Male or Female *

Male

Female

Address *

City *

Zip *

School Attending *

Grade *

Date of Birth *

Month

Day

Year

Baptism *

Month

Day

Year

Name and Location of Church *

First Eucharist *

Month

Day

Year

Name and Location of Church *

Last CCD school attended

Date of attendance

Month

Day

Year

Parental Information

Father's Name *

Religion *

Address *

Cell Phone Number *

Work Phone Number *

Email *

Mother's Name *

Religion *

Address *

Cell Phone Number *

Work Phone Number

Email *

In an emergency call *

Name and Phone Number Other Than Parent

Church Parish where you are registered or attend Mass regularly *

Does your child have any allergies or special needs? *

Photo Permissions *

Yes

Parent Signature *

Please type your name to give permission for your child to participate.

$30 REGISTRATION FEE
CHECK YOUR EMAIL TO PAY ONLINE OR FEES CAN BE PAID BY CHECK (OLPS CCD) OR CASH

Questions? Call Shelley Michiels, Director of Religious Education, at (318) 445-3693 ext. 211 or email shelley.michiels@olpschurch.org for more information.

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