CCD Registration 2023-24 Form

Family Last Name REQUIRED Please fill out this field. Please enter valid data.

Street Address REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Head of Household (First and Last Name) REQUIRED Please fill out this field. Please enter valid data.

Religion REQUIRED Please fill out this field. Please enter valid data.

Email REQUIRED Please fill out this field. Please enter an email address.

Cell Phone REQUIRED Please fill out this field. Please enter a phone number.

Home Phone Please enter a phone number.

What Sacraments have you completed? Check all that apply. REQUIRED Baptism First Communion Confirmation Marriage (by a Catholic priest or deacon) None Please fill out this field.

Spouse (First and Last Name) Please enter valid data.

Religion REQUIRED Please fill out this field. Please enter valid data.

Email Please enter an email address.

Cell Phone REQUIRED Please fill out this field. Please enter a phone number.

Home Phone Please enter a phone number.

What Sacraments has your spouse completed? Baptism First Communion Confirmation Marriage (by a Catholic priest or deacon) None

Emergency Contact (First and Last Name) REQUIRED Please fill out this field. Please enter valid data.

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Relationship to child(ren) REQUIRED Please fill out this field. Please enter valid data.

Number of Children you are registering REQUIRED Please fill out this field.
Child 1
- 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 sex REQUIRED male female Please fill out this field.
- Grade in 2023-24 REQUIRED Please fill out this field. Please enter valid data.
- Sacraments received (check all that apply): REQUIRED Baptism First Communion Has not received any sacraments yet Please fill out this field.
- Date of Baptism Please enter a date.
- Place of Baptism (Name of Parish, City, State) Please enter valid data.
- Date of First Communion Please enter a date.
- Place of First Communion (Name of Parish, City, State) Please enter valid data.
- Food allergies, Other Allergies, Other Medical Conditions REQUIRED Please fill out this field.
- Any special needs? REQUIRED Please fill out this field.
Child 2
- 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 sex REQUIRED male female Please fill out this field.
- Grade in 2023-24 REQUIRED Please fill out this field. Please enter valid data.
- Sacraments received (check all that apply): REQUIRED Baptism First Communion Has not received any sacraments yet Please fill out this field.
- Date of Baptism Please enter a date.
- Place of Baptism (Name of Parish, City, State) Please enter valid data.
- Date of First Communion Please enter a date.
- Place of First Communion (Name of Parish, City, State) Please enter valid data.
- Food allergies, Other Allergies, Other Medical Conditions REQUIRED Please fill out this field.
- Any special needs? REQUIRED Please fill out this field.
Child 3
- 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 sex REQUIRED male female Please fill out this field.
- Grade in 2023-24 REQUIRED Please fill out this field. Please enter valid data.
- Sacraments received (check all that apply): REQUIRED Baptism First Communion Has not received any sacraments yet Please fill out this field.
- Date of Baptism Please enter a date.
- Place of Baptism (Name of Parish, City, State) Please enter valid data.
- Date of First Communion Please enter a date.
- Place of First Communion (Name of Parish, City, State) Please enter valid data.
- Food allergies, Other Allergies, Other Medical Conditions REQUIRED Please fill out this field.
- Any special needs? REQUIRED Please fill out this field.
Child 4
- 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 sex REQUIRED male female Please fill out this field.
- Grade in 2023-24 REQUIRED Please fill out this field. Please enter valid data.
- Sacraments received (check all that apply): REQUIRED Baptism First Communion Has not received any sacraments yet Please fill out this field.
- Date of Baptism Please enter a date.
- Place of Baptism (Name of Parish, City, State) Please enter valid data.
- Date of First Communion Please enter a date.
- Place of First Communion (Name of Parish, City, State) Please enter valid data.
- Food allergies, Other Allergies, Other Medical Conditions REQUIRED Please fill out this field.
- Any special needs? REQUIRED Please fill out this field.
Child 5
- 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 sex REQUIRED male female Please fill out this field.
- Grade in 2023-24 REQUIRED Please fill out this field. Please enter valid data.
- Sacraments received (check all that apply): REQUIRED Baptism First Communion Has not received any sacraments yet Please fill out this field.
- Date of Baptism Please enter a date.
- Place of Baptism (Name of Parish, City, State) Please enter valid data.
- Date of First Communion Please enter a date.
- Place of First Communion (Name of Parish, City, State) Please enter valid data.
- Food allergies, Other Allergies, Other Medical Conditions REQUIRED Please fill out this field.
- Any special needs? REQUIRED Please fill out this field.
Child 6
- 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 sex REQUIRED male female Please fill out this field.
- Grade in 2023-24 REQUIRED Please fill out this field. Please enter valid data.
- Sacraments received (check all that apply): REQUIRED Baptism First Communion Has not received any sacraments yet Please fill out this field.
- Date of Baptism Please enter a date.
- Place of Baptism (Name of Parish, City, State) Please enter valid data.
- Date of First Communion Please enter a date.
- Place of First Communion (Name of Parish, City, State) Please enter valid data.
- Food allergies, Other Allergies, Other Medical Conditions REQUIRED Please fill out this field.
- Any special needs? REQUIRED Please fill out this field.
Child 7
- 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 sex REQUIRED male female Please fill out this field.
- Grade in 2023-24 REQUIRED Please fill out this field. Please enter valid data.
- Sacraments received (check all that apply): REQUIRED Baptism First Communion Has not received any sacraments yet Please fill out this field.
- Date of Baptism Please enter a date.
- Place of Baptism (Name of Parish, City, State) Please enter valid data.
- Date of First Communion Please enter a date.
- Place of First Communion (Name of Parish, City, State) Please enter valid data.
- Food allergies, Other Allergies, Other Medical Conditions REQUIRED Please fill out this field.
- Any special needs? REQUIRED Please fill out this field.
Child 8
- 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 sex REQUIRED male female Please fill out this field.
- Grade in 2023-24 REQUIRED Please fill out this field. Please enter valid data.
- Sacraments received (check all that apply): REQUIRED Baptism First Communion Has not received any sacraments yet Please fill out this field.
- Date of Baptism Please enter a date.
- Place of Baptism (Name of Parish, City, State) Please enter valid data.
- Date of First Communion Please enter a date.
- Place of First Communion (Name of Parish, City, State) Please enter valid data.
- Food allergies, Other Allergies, Other Medical Conditions REQUIRED Please fill out this field.
- Any special needs? REQUIRED Please fill out this field.
Child 9
- 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 sex REQUIRED male female Please fill out this field.
- Grade in 2023-24 REQUIRED Please fill out this field. Please enter valid data.
- Sacraments received (check all that apply): REQUIRED Baptism First Communion Has not received any sacraments yet Please fill out this field.
- Date of Baptism Please enter a date.
- Place of Baptism (Name of Parish, City, State) Please enter valid data.
- Date of First Communion Please enter a date.
- Place of First Communion (Name of Parish, City, State) Please enter valid data.
- Food allergies, Other Allergies, Other Medical Conditions REQUIRED Please fill out this field.
- Any special needs? REQUIRED Please fill out this field.
Child 10
- 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 sex REQUIRED male female Please fill out this field.
- Grade in 2023-24 REQUIRED Please fill out this field. Please enter valid data.
- Sacraments received (check all that apply): REQUIRED Baptism First Communion Has not received any sacraments yet Please fill out this field.
- Date of Baptism Please enter a date.
- Place of Baptism (Name of Parish, City, State) Please enter valid data.
- Date of First Communion Please enter a date.
- Place of First Communion (Name of Parish, City, State) Please enter valid data.
- Food allergies, Other Allergies, Other Medical Conditions REQUIRED Please fill out this field.
- Any special needs? REQUIRED Please fill out this field.

Occasionally CCD children's pictures may be posted on the St. Michael's website. Do you give permission for your child(ren)'s picture to be used? REQUIRED Yes, you can use my child's picture No - do not use Please fill out this field.

Medical Emergency: I understand that reasonable precautions will be taken to safeguard the health and wellbeing of the participants in this Parish School of Religion program and that I will be notified as soon as possible in the event of an emergency. In the case of sickness or an accident, I authorize and consent the Director of the Parish School of Religion, or associated colunteers of the Parish School of Religion program to obtain medical care from a licensed physician, hospital, or medical clinic for my son/daughter in the event that I, or other legal guardian(s), cannot be reached. I hereby do reliease and forever discharge this Diocese and Parish from all manner of actions or claims which I or the child named above shall or may have for any reason, arising during my child's attendance at the Parish School of Religion at Our Lady Help of Christians.

I Agree Please select this field.

St. Michael Catholic Parish
& Mission of St. Dominic

Brandywine / Aquasco, MD

CCD Registration 2023-24 Form