Our Lady of Lourdes Catechesis Registration 2019/20 for K-6
One registration per child, please.
Child's Full Name, first and last *
Your answer
Grade Level of Child
Preferred Parent Phone *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
School Attending *
Your answer
City of Birth *
Your answer
Preferred Parent Email
Your answer
Father's Full Name *
Your answer
Father's Phone Number *
Your answer
Father's Email *
Your answer
Father's Religion *
Mother's Full Name, First and Last *
Your answer
Mother's Maiden Name *
Your answer
Mother's Phone Number *
Your answer
Mother's Email *
If the family shares an email, please reenter the email here.
Your answer
Mother's Religion *
Mailing Address (Number and Street) *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Registered in the Parish *
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