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CCD Registration

- Religious Education

CCD Registration Form
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- Parent Information
  
  Father's Name Please enter valid data.
  
  Mother's Name Please enter valid data.
  
  Mother's Maiden Name Please enter valid data.
  
  Child Lives with (Name and Relationship to child, if different from parents) Please enter valid data.
  
  Mailing Address Please enter valid data.
  
  Home Phone Please enter valid data.
  
  Mom Cell # Please enter valid data.
  
  Dad Cell # Please enter valid data.
  
  Parent Email Please enter valid data.
  
  Emergency Contact Name Please enter valid data.
  
  Emergency Contact Phone Please enter valid data.
- Number of Children Registering for CCD Please enter an integer (number).
- About Child 1
  
  Name: Child 1 REQUIRED Please fill out this field. Please enter valid data.
  
  Grade Entering 2022-2023: Child 1 REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Gender: Child 1 REQUIRED Male Female Please fill out this field.
  
  Please let us know if there is anything you feel we should know about your child to better serve his/her needs. Medical, Emotional, Physical, and Academic
- Sacramental Information: Child 1
  
  Baptism Date, Church, City, State REQUIRED Please fill out this field. Please enter valid data.
  
  First Penance, Date, Church, City, State Please enter valid data.
  
  Holy Eucharist, Date, Church, City, State Please enter valid data.
  
  Confirmation, Date, Church, City, State Please enter valid data.
- About Child 2
  
  Name Please enter valid data.
  
  Grade Entering 2022-2023 Please enter valid data.
  
  Date of Birth Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Please let us know if there is anything you feel we should know about your child to better serve his/her needs. Medical, Emotional, Physical, and Academic
- Sacramental Information: Child 2
  
  Baptism Date, Church, City, State REQUIRED Please fill out this field. Please enter valid data.
  
  First Penance, Date, Church, City, State Please enter valid data.
  
  Holy Eucharist, Date, Church, City, State Please enter valid data.
  
  Confirmation, Date, Church, City, State Please enter valid data.
- About Child 3
  
  Name Please enter valid data.
  
  Grade Entering 2022-2023 Please enter valid data.
  
  Date of Birth Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Please let us know if there is anything you feel we should know about your child to better serve his/her needs. Medical, Emotional, Physical, and Academic
- Sacramental Information: Child 3
  
  Baptism Date, Church, City, State REQUIRED Please fill out this field. Please enter valid data.
  
  First Penance, Date, Church, City, State Please enter valid data.
  
  Holy Eucharist, Date, Church, City, State Please enter valid data.
  
  Confirmation, Date, Church, City, State Please enter valid data.
- About Child 4
  
  Name Please enter valid data.
  
  Grade Entering 2022-2023 Please enter valid data.
  
  Date of Birth Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Please let us know if there is anything you feel we should know about your child to better serve his/her needs. Medical, Emotional, Physical, and Academic
- Sacramental Information: Child 4
  
  Baptism Date, Church, City, State REQUIRED Please fill out this field. Please enter valid data.
  
  First Penance, Date, Church, City, State Please enter valid data.
  
  Holy Eucharist, Date, Church, City, State Please enter valid data.
  
  Confirmation, Date, Church, City, State Please enter valid data.
- Registration Fee
Total:

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St. Henry Catholic Church

Lake Charles, LA

CCD Registration

CCD Registration Form