CCD Registration - Our Lady Queen of Angels

Child's Name*

First Last Suffix

Grade*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Home Phone

Cell Phone*

Email*

Relevant Health Concerns

Parent/Guardian Name

First Last

Emergency Contact

First Last Relationship to Child

Phone

Adults permitted to pick up child(ren) from CCD

First Last

Adults permitted to pick up child(ren) from CCD

First Last

Adults permitted to pick up child(ren) from CCD

First Last

Social Media Concent*

I do give my permission.
I do not give my permission

Do you give permission for pictures taken during religious education/parish events to be used on parish website/social media account for Our Lady Queen of Angels Parish?

Name*

First Last

Please type your name to sign this form.

Registration 24-25