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CCD

- Religious Education
  - CCD/Youth Group/Confirmation Registration
  - RCIA

- CCD REGISTRATION FORM 2016-2017
- Safe Touch Form must be signed and returned to Sacred Heart School
CCD/Youth Group/Confirmation
Registration 2016-2017
The maximum number of form submissions has been reached. This form is currently not available.
- Child's Information
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last 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.
  
  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.
  
  Age REQUIRED Please fill out this field.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field.
- Is your child Baptized? REQUIRED Yes No Please fill out this field.
- If YES, Where and approximate date:
- Has your child made his/her First Holy Communion? REQUIRED Yes No Please fill out this field.
- If YES, where and approximate date:
- Has your child made his/her Confirmation? REQUIRED Yes No Please fill out this field.
- If YES, Where and approximate date:
- Was your child registered for Religious Education at Sacred Heart last year? REQUIRED Yes No Please fill out this field.
- If NO, please specify where:
- Father's Information (if applicable)
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  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.
- Mother's Information (if applicable)
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  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.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
- Emergency Contact
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  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.
- I understand that reasonable precautions will be taken to safeguard the health and well-being of the participant in religious education classes for the year 2016-2017 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 teacher or other associated volunteers of the program to obtain medical care from a licensed physician, hospital, or medical clinic for my son/daughter in the event that myself or other legal guardian(s) cannot be reached. I hereby do release and forever discharge this Diocese, Sacred Heart Parish and/or Organization from all manners of actions, claims which I or the child named above shall or may have for any reason arising during my child's attendance of the program.
  
  Unless other written instructions is submitted, I also consent to allowing mu child's image to be recorded, either by photograph or video, and used during the year 2016-2017 or for future advertisement of Parish programs. I understand that these photographs may be used in parish publications, for bulletin boards, or parish Web-Site, art projects as well as social media including Facebook, Instagram, and Twitter.
  
  NOTE: Please Click on "Safe Touch Form" (the link above this registration), sign it and please return to the parish office or to the Religious Education office to complete this registration. Thank you.
  
  I Agree Please select this field.
- Tuition is FREE$0.0
Total: $

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Sacred Heart Church

Clovis, New Mexico

CCD

CCD/Youth Group/Confirmation
Registration 2016-2017