Child's Name

First Name

Last Name

Child's Birth Date

MM

DD

YYYY

Previous Religious Education Completed

Check all that apply

Pre-K

Kindergarten

First

Second

Third

Fourth

Fifth

Sixth

Seventh

Eighth

Please check all sacraments your child has received *

Baptism

Reconciliation

First Communion

Confirmation

Mother's Name

First Name

Last Name

Father's Name

First Name

Last Name

Primary Phone

(###)

###

####

Mother Cell Phone

(###)

###

####

Father Cell Phone

(###)

###

####

I give permission for Old Town Parishes Religious Education program to take and use photographs, video, and audio or other digital recordings of my child(ren) for public relations purposes, including, but not limited to, use on the parish website, facebook page, the Sunday bulletin, brochures or other publications produced by the Church. I understand that, in use of such materials, my child(ren)'s name(s) will not be disclosed.

I agree

I disagree