Facebook Phone Flocknote

CCD Registration

- Religious Education

CCD Registration Form
The maximum number of form submissions has been reached. This form is currently not available.
- Parent Information
  
  Father's Name | Nombre del Padre Please enter valid data.
  
  Mother's Name | Nombre de la Madre Please enter valid data.
  
  Mother's Maiden Name | Nombre de Soltera de la Madre Please enter valid data.
  
  Child Lives with(Name and Relationship to child, if different from parents) | El/la Niñ@ vive con(Nombre y relacion con el/la niñ@ si es diferente de los padres) Please enter valid data.
  
  Mailing Address | Dirección Please enter valid data.
  
  Home Phone | Número de Teléfono de la Casa Please enter valid data.
  
  Mom Cell # Please enter valid data.
  
  Dad Cell # Please enter valid data.
  
  Parent Email | Correo electrónico de padres Please enter valid data.
  
  Emergency Contact Name | Nombre del contacto de emergencia Please enter valid data.
  
  Emergency Contact Phone | Número telefónico del contacto de emergencia Please enter valid data.
- Number of Children Registering for CCD | Nombre de niños Registrados en CCD Please enter an integer (number).
- About Child 1
  
  Name: Child 1 | Nombre: Niñ@ 1 REQUIRED Please fill out this field. Please enter valid data.
  
  Grade Entering 2023-2024: Child 1 | Grado escolar 2023-2024 al que entra: Niñ@1 REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth | Fecha de Nacimiento REQUIRED Please fill out this field. Please enter valid data.
  
  Gender: Child 1 | Genero: Niñ@ 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 | Informacion Sacramental: Niñ@ 1
  
  Baptism Date, Church, City, State | Fecha de Bautizo, Iglesia, City, Estado REQUIRED Please fill out this field. Please enter valid data.
  
  First Penance, Date, Church, City, State | fecha de Primera Confesion, Iglesia, Ciudad, Estado 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 2023-2024 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 2023-2024 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 2023-2024 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:

Submit

Pay Now

Pay Later

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

St. Henry Catholic Church

Lake Charles, LA

CCD Registration

CCD Registration Form