Our Lady of Lourdes Catechesis Registration 2017/18
One registration per child, please.
For Learning to Love, EDGE, Life Teen, and Sacrament Preparation
Student's First Name *
Your answer
Student's Middle Name *
Your answer
Student's Last Name *
Your answer
School Attending *
Your answer
Grade *
Date of Birth *
MM
/
DD
/
YYYY
Gender *
Preferred Parent Contact *
Father's First Name *
Your answer
Father's Last Name *
Your answer
Father's Phone Number *
Your answer
Father's Email *
Your answer
Father's Religion *
Mother's First Name *
Your answer
Mother's Last 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 *
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Registered *
Envelope Number
Your answer
If Needed, Please Register in the Parish Here
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