Adult Registration Form
Please complete 1 form for each adult who plans to attend classes this Fall. This is a Confidential Information Inquiry form for all.  Stages of students in class range from inquiry to full initiation. 

**Please note, you will need to send us your Baptism (or Birth certificate if not Baptized), Communion & Confirmation certificates (if applicable) to cce@stlukecc.org to complete your registration. These forms can also be brought to our office at 2800 Rockwell Drive, Brownsville, Texas 78521.
Please be sure to gather documents before proceeding.
 
Adult classes will take place in the Religious Education building beginning in the Fall (usually from 6:30-8pm on Monday evenings). For more info, please call (956) 541-0184 (leave a detailed message). Thank you!
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Email *
First Name: *
Please spell name as it is listed on your Birth Certificate.
Middle Name *
Last Name *
Physical Address: *
City: *
Zip Code: *
Primary Phone: *
Secondary Phone: *
Date of Birth: *
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/
DD
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Age: *
Are you a registered parishioner? *
Registered parishioners typically receive direct mail from our parish/ envelopes for giving.
Language spoken? *
Current College student? *
Current Place of Employment? *
Please include hours worked during the week to help us with scheduling; if not employed, please mark n/a
Media *
I hereby give my consent to all photographs, audio recordings, work, and/or video recordings taken of me or my minor child(ren) by any parish in the diocese and/or Saint Luke parish staff or their designee.  I understand that such photographs, audio recordings, work, and/or video recordings become the property of the diocese and/or parish and may be used by the diocese, parish and/or others with their consent, for educational, instructional, or promotional purposes determined by the diocese and/or parish in broadcast and electronic media formats now existing or in the future created.
Medical *
I give consent for the person named on this form to participate in the parish programs and physical activities during the current program year.  I authorize the employees and/or responsible personnel to obtain proper medical treatments should it become necessary.  I agree on behalf of myself to hold harmless and release the parish, the Diocese of Brownsville, the Bishop and his successors, all of their employees, directors, administrators, catechists and volunteers from all legal liability for illnesses, injuries and/or death suffered as a result of participation in the programs and physical activities during the program year.  I further agree to compensate the parish, the Diocese of Brownsville, its directors, employees and/or agents associated with the programs and physical activities for reasonable attorney's fees and expenses which may incur in any action brought against them as a result of such injury or damage (unless such claim arises from the negligence of the parish/diocese).  I affirm that the information above is true and correct.
Medical/Allergies/Limitations *
Health or Medical Conditions, Food Allergies or Limitations not previously listed on this form (please include any the director would need to be aware of during in person classes)
Are you Baptized? *
If yes, which denomination? *
I go to church on a: *
Do you currently attend a Catholic church? *
Please list the name of the parish you attend most regularly. *
or n/a if none
I am Baptized. *
Required
If received Baptism, please list the Name of the church & Date received. *
or None
I have received the Sacrament of Confession. *
Required
I have received the Sacrament of Communion (Eucharist). *
Required
If received Eucharist, please list the Name of the church & Date received. *
or None
I have received the Sacrament of Confirmation. *
Required
If received Confirmation, please list the Name of the church & Date received. *
or None
I have received the Sacrament of Matrimony *
Required
If received Matrimony, please list the Name of the church & Date received. *
or None
As we journey towards the reception of sacraments, we ask that you check the boxes that apply to you: *
Required
Is there any other info you would like to add about yourself? *
As part of the St. Luke Parish Christian Initiation classes for Adults we ask all entering the program to take the opportunity to meet with the pastor or deacon so that he can welcome you and offer any spiritual assistance as you inquire into the sacraments of the church and possibly seek full communion in the church. We will forward this registration to him and/or the deacon.  You may be asked to call and set up your visit as we discuss which sacraments you will be receiving.  You should plan attend CI classes while simultaneously awaiting your call and/or meeting.  Our program requests a $30 donation to assist with costs to the program. Texts provided for your use: Catholic Bible, Catechism of the Catholic Church, Visions.  Donations can be made on our parish registration page (please see directions there).  Thank you!
Click Submit to complete the registration form. Thank you!
A copy of your responses will be emailed to the address you provided.
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