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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