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CCD Registration

- CCD/Religious Ed

Please Note and make sure to write which Parish (Church) your child was baptized. We will need a copy of their Baptismal Certificate if they are recieving any sacraments this year. If your child is in 2nd Grade we will need a copy since they will be recieving their First Eucharist this year.
CCD Registration 2022-2023
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- Today's Date: REQUIRED Please fill out this field. Please enter a date.
- Parent/Guardian Information
  
  Father REQUIRED Please fill out this field. Please enter valid data.
  
  Father's Cell # REQUIRED Please fill out this field. Please enter valid data.
  
  Mother REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Maiden Name: REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Cell # REQUIRED Please fill out this field. Please enter valid data.
  
  Whose Phone Number is the Primary? REQUIRED Mom Dad Please fill out this field.
  
  Child lives with: REQUIRED Please fill out this field. Please enter valid data.
  
  Relationship to Child: REQUIRED Please fill out this field. Please enter valid data.
  
  Mailing Address: REQUIRED Please fill out this field. Please enter valid data.
  
  City: REQUIRED Please fill out this field. Please enter valid data.
  
  Zip Code: REQUIRED Please fill out this field. Please enter valid data.
  
  E-mail Address: REQUIRED Please fill out this field. Please enter valid data.
  
  Primary Phone # REQUIRED Please fill out this field. Please enter valid data.
  
  Emergency Contact REQUIRED Please fill out this field. Please enter valid data.
  
  Relationship to Child: REQUIRED Please fill out this field. Please enter valid data.
  
  Phone # REQUIRED Please fill out this field. Please enter valid data.
- Child #1:
  
  Name REQUIRED Please fill out this field. Please enter valid data.
  
  DOB: REQUIRED Please fill out this field. Please enter valid data.
  
  Gender: Male Female
  
  Grade (in which they are entering) REQUIRED Please fill out this field.
  
  CCD Times Grades 1-5 @ 4pm Grades 1-5 @ 5:30pm Grades 6-8 @ 7pm
  
  City of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Church of Baptism REQUIRED Please fill out this field. Please enter valid data.
  
  City & State of Baptism REQUIRED Please fill out this field. Please enter valid data.
  
  Sacraments Completed: Baptism Confession Communion
  
  Sacramental preparation needed this year? Yes No
  
  SPECIAL NEEDS/COMMENTS: (medical, learning, physical or special requests):
  
  Birth Father: Please enter valid data.
  
  Cell # Please enter valid data.
  
  Birth Mother: Please enter valid data.
  
  Cell # Please enter valid data.
  
  Mother's Maiden Name: Please enter valid data.
- Child #2:
  
  Name Please enter valid data.
  
  DOB: Please enter valid data.
  
  Gender: Male Female
  
  Grade
  
  CCD Times Grades 1-5 @ 4pm Grades 1-5 @ 5:30pm Grades 6-8 @ 7pm
  
  City of Birth Please enter valid data.
  
  City & State of Baptism Please enter valid data.
  
  Church of Baptism Please enter valid data.
  
  Sacraments Completed: Baptism Confession Communion
  
  Sacramental preparation needed this year? Yes No
  
  SPECIAL NEEDS/COMMENTS: (medical, learning, physical or special requests):
  
  If different birth father/mother please fill the following:
  
  Birth Father: Please enter valid data.
  
  Cell # Please enter valid data.
  
  Birth Mother: Please enter valid data.
  
  Cell # Please enter valid data.
  
  Mother's Maiden Name: Please enter valid data.
- Child #3:
  
  Name Please enter valid data.
  
  DOB: Please enter valid data.
  
  Gender: Male Female
  
  Grade
  
  CCD Times Grades 1-5 @ 4pm Grades 1-5 @ 5:30pm Grades 6-8 @ 7pm
  
  City of Birth Please enter valid data.
  
  Church of Baptism Please enter valid data.
  
  City & State of Baptism Please enter valid data.
  
  Sacraments Completed: Baptism Confession Communion
  
  Sacramental preparation needed this year? Yes No
  
  SPECIAL NEEDS/COMMENTS: (medical, learning, physical or special requests):
  
  If different birth father/mother please fill the following:
  
  Birth Father: Please enter valid data.
  
  Cell # Please enter valid data.
  
  Birth Mother: Please enter valid data.
  
  Cell # Please enter valid data.
  
  Mother's Maiden Name: Please enter valid data.
- Other:
  
  Do we have permission to photograph your child for CCD, church website, and/or bulletin purposes? Yes No
  
  Do you attend Church at St. Theodore Catholic Church? REQUIRED Yes No Please fill out this field.
- PAYMENT IS:
  
  Please choose amount for 2022-2023 CCD $35 for ONE student in grades 1-8 $65 for TWO students in grades 1-8 $90 for THREE students in grades 1-8
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