Please fill out the following as accurately as possible, even though you may have filled it out last year. If there is a separate address or phone number for each parent, please include if you wish notification for both. The registration fee for this year is $20 for one student and $40 for two or more students. Please make all checks payable to St. Christopher’s CCD.

Father’s name:_________________________________________________________

Mother’s name (including maiden):________________________________________

Mailing Address:_______________________________________________________

                          _____________________________________________________

                          _____________________________________________________

E-mail Address (one you check often)______________________________________

Phone number:________________________________________________________

Name of Child:_______________________________________________________

Birthdate:___________________________________________________________

Baptism Church:____________________________________Date:_____________

First Communion Church:_____________________________Date:_____________

School Attending:___________________________________Grade:____________

Name of Child:_______________________________________________________

Birthdate:___________________________________________________________

Baptism Church:____________________________________Date:_____________

First Communion Church:_____________________________Date:_____________

School Attending:___________________________________Grade:____________

Name of Child:_______________________________________________________

Birthdate:___________________________________________________________

Baptism Church:____________________________________Date:_____________

First Communion Church:_____________________________Date:_____________

School Attending:___________________________________Grade:____________

Name of Child:_______________________________________________________

Birthdate:___________________________________________________________

Baptism Church:____________________________________Date:_____________

First Communion Church:_____________________________Date:_____________

School Attending:___________________________________Grade:____________

Name of Child:_______________________________________________________

Birthdate:___________________________________________________________

Baptism Church:____________________________________Date:_____________

First Communion Church:_____________________________Date:_____________

School Attending:___________________________________Grade:___

Would you be willing to be a substitute teacher?  _________________________  Which grades?___________________________

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