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  • Which Parish CCD are you registering for? REQUIRED St. Michael's Church St. Dominic's Church Please fill out this field.
  • Child's Full Name REQUIRED Please fill out this field. Please enter valid data.
  • Child's Date of Birth REQUIRED Please fill out this field. Please enter valid data.
  • Child's School Grade Level REQUIRED Please fill out this field. Please enter valid data.
  • Family Mailing Address REQUIRED Please fill out this field.
  • Email REQUIRED Please fill out this field. Please enter an email address.
  • Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  • Emergency contact - Name and phone number REQUIRED Please fill out this field.
  • Father's Full Name REQUIRED Please fill out this field. Please enter valid data.
  • Mother's Full Name REQUIRED Please fill out this field. Please enter valid data.
  • Who does the child reside with? Both parents Mother Father Other Relative / Guardian
  • Was child Baptized? REQUIRED Yes No Please fill out this field.
  • Date of Baptism REQUIRED Please fill out this field. Please enter valid data.
  • Parish of Baptism and City, State REQUIRED Please fill out this field. Please enter valid data.
  • Has child received First Holy Eucharist REQUIRED Yes No Please fill out this field.
  • Date of First Holy Eucharist? REQUIRED Please fill out this field. Please enter valid data.
  • Any health concerns / allergies? REQUIRED Please fill out this field.
  • Does your family have access to internet for email or possible homework assignments? REQUIRED Yes No Please fill out this field.
  • Occasionally CCD children's pictures may be posted on the parish website. Do you give permission for your childs picture to be used? If yes, you will receive a form once CCD starts requiring your signature for our files. REQUIRED Yes you can use my child's picture No - do not use Please fill out this field.
  • Tuition can be paid to the parish office or on the first night of CCD classes.

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