Student Information Child Name*
First
Middle
Last
Suffix
Address*
Home Phone*
Date of Birth*
MM slash DD slash YYYY
Gender* Male Female
Child Religion* 7th Day Adventist Baptist Catholic (Eastern) Catholic (Roman) Christian Episcopal Evangelical Friends Hindu Jewish Lutheran Methodist None Other Pentecostal Presbyterian Protestant United Church of Christ
CCD Grade Attending This Year* 1st Grade 2nd Grade 3rd Grade 4th grade 5th Grade 6th Grade 7th Grade 8th Grade
Please select the CCD grade your child will be attending beginning this year.
School Grade Attending This Year* Please select the CCD grade your child will be attending beginning September this year.
1st Grade 2nd Grade 3rd Grade 4th grade 5th Grade 6th Grade 7th Grade 8th Grade
All Saints - Active Parishioner Student's Parish/Church Please enter the parish/church last attended or currently attending.
Please Note: Parents who are not registered at ALL SAINTS must have a letter from their pastor stating that he is aware of and agrees
to your child attending CCD at All Saints Catholic Church.
Parent/Guardian Marital Status* Single Married Divorced Widowed Separated
Student Sacraments Is child baptized?* Please Note: Parents are required to
show proof of child’s baptism – a copy is to be placed in student’s permanent record file.
Would you like to schedule your child to be baptized? If your child has not been baptized yet, would you like to schedule your child to be baptized?
Sacrament of Reconciliation Has your child received their first Sacrament of Reconciliation?
Sacrament of Eucharist Has your child received their first Holy Communion?
Student's First Holy Communion Date
MM slash DD slash YYYY
Where did your child receive their first Holy Communion?
Please enter the name of the parish and address.
Sacrament of Confirmation Has your child received their Sacrament of Confirmation?
Student Medical Information Allergies* Does student have any allergies?
Allergies Epipen* Does student have an epipen they carry for severe allergies?
Student Allergies Please list in detail all of your child's allergies and any emergency procedures we need to be aware related to each allergy.
Asthma* Does student have asthma?
Student Asthma Please list in detail any emergency procedures we need to be aware for your child in case of an asthmatic episode.
Other Medical Information* Does student have any other medical information (i.e., ADD, ADHD, Asperger, Autism, Dyslexia, etc.) we need to be aware of during CCD class?
Student Other Medical Information Details Please list in detail any other medical information we need to be aware for your child.
Special Education Information Special Education* Does your child have an IEP or special education plan they follow in school to help them learn?
Special Education IEP/Plan information Please list in detail any information we need to be aware of to help your child learn during CCD class.
Parent/Guardian Information Father/Guardian Name* Father/Guardian Full Name including Suffix
First
Middle
Last
Suffix
Father/Guardian Address Is the father's guardian's address same as student?
Father/Guardian Address
Enter the father/guardian address that is different from the student address.
Father/Guardian Religion 7th Day Adventist Baptist Catholic (Eastern) Catholic (Roman) Christian Episcopal Evangelical Friends Hindu Jewish Lutheran Methodist None Other Pentecostal Presbyterian Protestant United Church of Christ
Father/Guardian Cell*
Father/Guardian Email*
Mother/Guardian Name*
First
Middle
Last
Mother/Guardian Maiden Name*
Mother/Guardian Address Is the mother's guardian's address same as student?
Mother/Guardian Address
Enter the mother/guardian address that is different from the student address.
Mother/Guardian Religion 7th Day Adventist Baptist Catholic (Eastern) Catholic (Roman) Christian Episcopal Evangelical Friends Hindu Jewish Lutheran Methodist None Other Pentecostal Presbyterian Protestant United Church of Christ
Mother/Guardian Cell*
Mother/Guardian Email*
Parent/Guardians Place of Marriage Please list the parents/guardians place of marriage.
Parent/Guardian Address of Place of Marriage
Does child have a stepparent? Check all that apply.
Student Stepparent Information Stepfather Name* Stepfather Full Name including Suffix
First
Middle
Last
Suffix
Stepfather Address Is the stepfather's guardian's address same as student?
Stepfather Home Address
Stepfather Religion 7th Day Adventist Baptist Catholic (Eastern) Catholic (Roman) Christian Episcopal Evangelical Friends Hindu Jewish Lutheran Methodist None Other Pentecostal Presbyterian Protestant United Church of Christ
Stepfather Cell*
Stepfather Email*
Stepmother Name* Stepmother Full Name including Suffix
First
Middle
Last
Suffix
Stepmother Address Is the stepfather's guardian's address same as student?
Stepmother Home Address
Stepmother Religion 7th Day Adventist Baptist Catholic (Eastern) Catholic (Roman) Christian Episcopal Evangelical Friends Hindu Jewish Lutheran Methodist None Other Pentecostal Presbyterian Protestant United Church of Christ
Stepmother Cell*
Stepmother Email*
Register More Students Would you like to register another child(ren) for CCD this year?* Register Second Child Would you like to register a second child?
Register Third Child Would you like to register a third child?
Register Fourth Child* Would you like to register a fourth child?
Second Child Information Please complete the student information below for the second child.
2nd Child Name*
First
Middle
Last
Suffix
2nd Child Date of Birth*
MM slash DD slash YYYY
2nd Child Gender* Male Female
2nd Child CCD Grade Attending This Year* 1st Grade 2nd Grade 3rd Grade 4th grade 5th Grade 6th Grade 7th Grade 8th Grade
Please select the CCD grade your child will be attending beginning this year.
2nd Child School Grade Attending This Year* Please select the CCD grade your child will be attending beginning September this year.
1st Grade 2nd Grade 3rd Grade 4th grade 5th Grade 6th Grade 7th Grade 8th Grade
Second Child's Address Does the second child live at the same addresss as the first child you are registering for CCD this year?
Second Child Address Please enter the address for the second child you are registering that is different from the first child you are registering.
Second Child All Saints - Active Parishioner 2nd Child Student's Parish/Church Please enter the parish/church last attended or currently attending.
Please Note: Parents who are not registered at ALL SAINTS must have a letter from their pastor stating that he is aware of and agrees
to your child attending CCD at All Saints Catholic Church.
2nd Child Parent/Guardian Marital Status* Single Married Divorced Widowed Separated
Second Child Parent/Guardian Information Second Child Parents/Guardian Are the second child's parents/guardians the same as the first child?
New 2nd Child Parent/Guardian Name Please enter the parent/guardian name that is different from the first child: mother/guardian, father/guardian, stepfather, stepmother.
First
Middle
Last
Suffix
New 2nd Child Parent/Guardian Relationship Father/Guardian Mother/Guardian Stepfather Stepmother
Please select the relationship of this new parent/guardian to the second child you are registering.
New 2nd Child Parent/Guardian Address Information Does this parent/guardian live at the same address as the second child you are registering for CCD this year?
New 2nd Child Parent/Guardian Address
Please enter the home address for the parent/guardian that is different from the second child you are registering this year.
New 2nd Child Parent/Guardian Cell Enter the cell phone number for the parent/guardian that is different from the first child you are registering this year.
New 2nd Child Parent/Guardian Email
Enter the email address for the parent/guardian that is different from the first child you are registering this year.
Second Child Student Sacraments Is second child baptized?* Would you like to schedule your second child to be baptized? If your second child has not been baptized yet, would you like to schedule your child to be baptized?
Sacrament of Reconciliation Has your second child received their first Sacrament of Reconciliation?
Sacrament of Eucharist Has your second child received their first Holy Communion?
Sacrament of Confirmation Has your second child received their Sacrament of Confirmation?
Second Child Student Medical Information Second Child Allergies* Does student have any allergies?
Second Child Allergies Epipen* Does student have an epipen they carry for severe allergies?
Second Child Student Allergies Please list in detail all of your child's allergies and any emergency procedures we need to be aware related to each allergy.
Second Child Asthma* Does student have asthma?
Second Student Asthma Please list in detail any emergency procedures we need to be aware for your second child in case of an asthmatic episode.
Second Child Other Medical Information* Does student have any other medical information (i.e., ADD, ADHD, Asperger, Autism, Dyslexia, etc.) we need to be aware of during CCD class?
Second Student Other Medical Information Details Please list in detail any other medical information we need to be aware for your child.
Second Child Special Education Information Second Child Special Education* Does your child have an IEP or special education plan they follow in school to help them learn?
Second Child Special Education IEP/Plan information Please list in detail any information we need to be aware of to help your child learn during CCD class.
Third Child Student Information Third Child Name*
First
Middle
Last
Suffix
Third Child's Address Does the third child live at the same addresss as the first child you are registering for CCD this year?
Third Child Address Please enter the address for the third child you are registering that is different from the first child you are registering.
Third Child Date of Birth*
MM slash DD slash YYYY
Third Child Gender* Male Female
Third Child CCD Grade Attending This Year* 1st Grade 2nd Grade 3rd Grade 4th grade 5th Grade 6th Grade 7th Grade 8th Grade
Please select the CCD grade your child will be attending beginning this year.
Third Child School Grade Attending This Year* Please select the CCD grade your child will be attending beginning September this year.
1st Grade 2nd Grade 3rd Grade 4th grade 5th Grade 6th Grade 7th Grade 8th Grade
3rd Child All Saints - Active Parishioner 3rd Child Student's Parish/Church Please enter the parish/church last attended or currently attending.
Please Note: Parents who are not registered at ALL SAINTS must have a letter from their pastor stating that he is aware of and agrees
to your child attending CCD at All Saints Catholic Church.
Third Child Parent/Guardian Marital Status* Single Married Divorced Widowed Separated
Third Child Parent/Guardian Information Third Child Parents/Guardian Are the third child's parents/guardians the same as the first child?
New 3rd Child Parent/Guardian Name Please enter the parent/guardian name that is different from the first child: mother/guardian, father/guardian, stepfather, stepmother.
First
Middle
Last
Suffix
New 3rd Child Parent/Guardian Relationship Father/Guardian Mother/Guardian Stepfather Stepmother
Please select the relationship of this new parent/guardian to the second child you are registering.
New 3rd Child Parent/Guardian Address Information Does this parent/guardian live at the same address as the third child you are registering for CCD this year?
New 3rd Child Parent/Guardian Address
Please enter the home address for the parent/guardian that is different from the third child you are registering this year.
New 3rd Child Parent/Guardian Cell Enter the cell phone number for the parent/guardian that is different from the first child you are registering this year.
New 3rd Child Parent/Guardian Email
Enter the email address for the parent/guardian that is different from the first child you are registering this year.
Third Child Student Sacraments Is third child baptized?* Would you like to schedule your third child to be baptized? If your third child has not been baptized yet, would you like to schedule your child to be baptized?
Sacrament of Reconciliation Has your third child received their first Sacrament of Reconciliation?
Sacrament of Eucharist Has your third child received their first Holy Communion?
Sacrament of Confirmation Has your third child received their Sacrament of Confirmation?
Third Child Student Medical Information Third Child Allergies* Does student have any allergies?
Third Child Allergies Epipen* Does student have an epipen they carry for severe allergies?
Third Child Student Allergies Please list in detail all of your child's allergies and any emergency procedures we need to be aware related to each allergy.
Third Child Asthma* Does student have asthma?
Third Child Asthma Information Please list in detail any emergency procedures we need to be aware for your child in case of an asthmatic episode.
Third Child Other Medical Information* Does student have any other medical information (i.e., ADD, ADHD, Asperger, Autism, Dyslexia, etc.) we need to be aware of during CCD class?
Third Student Other Medical Information Details Please list in detail any other medical information we need to be aware for your child.
Third Child Special Education Information Third Child Special Education* Does your child have an IEP or special education plan they follow in school to help them learn?
Third Child Special Education IEP/Plan information Please list in detail any information we need to be aware of to help your child learn during CCD class.
Fourth Child Student Information Fourth Child Name*
First
Middle
Last
Suffix
Fourth Child Date of Birth*
MM slash DD slash YYYY
Fourth Child Gender* Male Female
Fourth Child CCD Grade Attending This Year* 1st Grade 2nd Grade 3rd Grade 4th grade 5th Grade 6th Grade 7th Grade 8th Grade
Please select the CCD grade your child will be attending beginning this year.
Fourth Child School Grade Attending This Year* Please select the CCD grade your child will be attending beginning September this year.
1st Grade 2nd Grade 3rd Grade 4th grade 5th Grade 6th Grade 7th Grade 8th Grade
Fourth Child's Address Does the fourthchild live at the same addresss as the first child you are registering for CCD this year?
Fourth Child Address Please enter the address for the fourth child you are registering that is different from the first child you are registering.
4th Child All Saints - Active Parishioner 4th Child Student's Parish/Church Please enter the parish/church last attended or currently attending.
Please Note: Parents who are not registered at ALL SAINTS must have a letter from their pastor stating that he is aware of and agrees
to your child attending CCD at All Saints Catholic Church.
Fourth Child Parent/Guardian Marital Status* Single Married Divorced Widowed Separated
Fourth Child Parent/Guardian Information Fourth Child Parents/Guardian Are the fourth child's parents/guardians the same as the first child?
New 4th Child Parent/Guardian Name Please enter the parent/guardian name that is different from the first child: mother/guardian, father/guardian, stepfather, stepmother.
First
Middle
Last
Suffix
New 4th Child Parent/Guardian Relationship Father/Guardian Mother/Guardian Stepfather Stepmother
Please select the relationship of this new parent/guardian to the fourth child you are registering.
New 4th Child Parent/Guardian Address Information Does this parent/guardian live at the same address as the fourth child you are registering for CCD this year?
New 4th Child Parent/Guardian Address
Please enter the home address for the parent/guardian that is different from the fourth child you are registering this year.
New 4th Child Parent/Guardian Cell Enter the cell phone number for the parent/guardian that is different from the first child you are registering this year.
New 4th Child Parent/Guardian Email
Enter the email address for the parent/guardian that is different from the first child you are registering this year.
Fourth Child Student Sacraments Is fourth child baptized?* Would you like to schedule your fourth child to be baptized? If your fourth child has not been baptized yet, would you like to schedule your child to be baptized?
Sacrament of Reconciliation Has your fourth child received their first Sacrament of Reconciliation?
Sacrament of Eucharist Has your fourth child received their first Holy Communion?
Sacrament of Confirmation Has your fourth child received their Sacrament of Confirmation?
Fourth Child Student Medical Information Fourth Child Allergies* Does student have any allergies?
Fourth Child Allergies Epipen* Does student have an epipen they carry for severe allergies?
Fourth Child Student Allergies Please list in detail all of your child's allergies and any emergency procedures we need to be aware related to each allergy.
Fourth Child Asthma* Does student have asthma?
Fourth Student Asthma Information Please list in detail any emergency procedures we need to be aware for your third child in case of an asthmatic episode.
Fourth Child Asthma Please list in detail any emergency procedures we need to be aware for your child in case of an asthmatic episode.
Fourth Child Other Medical Information* Does student have any other medical information (i.e., ADD, ADHD, Asperger, Autism, Dyslexia, etc.) we need to be aware of during CCD class?
Fourth Student Other Medical Information Details Please list in detail any other medical information we need to be aware for your child.
Fourth Child Special Education Information Fourth Child Special Education* Does your child have an IEP or special education plan they follow in school to help them learn?
Fourth Child Special Education IEP/Plan information Please list in detail any information we need to be aware of to help your child learn during CCD class.
Emergency Contacts Please list who is authorized to be an emergency contact or carpool pick/drop for your child(red) other than the parents/guardians.
Please Note: If any one other than the custodial parent, a letter from the parent(s) is required that states who will be authorized to transport
your child. The parent must give the CCD teacher a note that someone other than the parent will be picking up the child.
1st Emergency Contact Name*
Dr. Miss Mr. Mrs. Ms. Mx. Prof. Rev.
Prefix
First
Last
1st Emergency Contact Phone
1st Contact - Pickup Authorization Is the first emergency contact authorized to pick your child in case of an emergency.
2nd Emergency Contact Name*
Dr. Miss Mr. Mrs. Ms. Mx. Prof. Rev.
Prefix
First
Last
2nd Emergency Contact Phone
2nd Contact - Pickup Authorization Is the first emergency contact authorized to pick your child in case of an emergency.
Parent/Guardian Consent Parent/Guardian Name* Please enter the parent/guardian name completing this CCD Registration Form.
First
Last
Parent/Guardian Email Please enter the email for the parent/guardian completing this CCD registration form.
Consent* Please review your information to make sure you have completed all questions accurately and have not missed any fields that need to be completed. Once you are satisfied with all the information, click on the Submit Registration button below. A confirmation email will be sent to you via email. Please contact the parish office if you have any questions. We look forward to helping your child grow spiritually in a deeper relationship with the Lord.
I agree to the privacy policy.
Registration Date
MM slash DD slash YYYY
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