Young Disciples Registration Form

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Young Disciples Registration Form

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* Indicates required question

Family Name *

Your answer

Parent 1 Name *

Your answer

Cell phone Number *

Your answer

Email Address

Your answer

Parent 2

Your answer

Cell phone number

Your answer

Home Address

Your answer

City

Your answer

State

Your answer

Zip Code

Your answer

It is very important that your child(ren) be present every week for class. Would you like us to arrange a ride for them? *

Yes

No

Other:

Child's Name

Your answer

Grade in School

Kindergarten

1

2

3

4

5

6

7

8

9

10

11

12

Clear selection

Which sacraments has he/she received?

Baptism

Reconciliation

First Communion

Confirmation

Other:

Do you have another child to enroll? *

Yes

No

Next

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