First Holy Communion Registration Form

Parent's Name

First Name

Last Name

Child lives with:

Mother

Father

Both

Other

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Emergency contact

Include their first and last name and phone number below:

Adult picking up child

Parish affiliation

Child's name

First Name

Last Name

Child goes by (Nickname)

Child's gender

Male

Female

Child's birthdate

YYYY

Please list the church where Baptism was received

Please list the school this child is currently attending

What grade is this child currently in?

Please list any comments that would be helpful for us to serve your children