CCD Registration 2020-2021 St. Ann Catholic Church * Hurley, MS

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This is an online registration form. Please fill out one per child.

Child's full name:

Name child goes by:

Grade:

Date of Birth:

YYYY

Place of Birth:

Mailing Address:

City:

State:

Zip Code:

Phone number:

Parent Email:

Father's full name:

Father's Religion:

Mother's full (maiden) name:

Mother's Religion:

OR Guardian:

Guardian Religion:

Sacraments Received

Baptism

First Penance

First Communion

Confirmation

Sacraments Needed THIS YEAR

Baptism

First Penance (2nd grade or up)

First Communion (2nd grade or up)

Confirmation (High School)

IF your child will be preparing for a sacrament this year.

Please complete the following information on the sacraments that your child has received.

Baptism: Date of Baptism: Church: City and the State of Church:

FIRST PENANCE: Date of First Penance: Church: City and the State of Church:

FIRST COMMUNION: Date of First Communion: Church: City and the State of Church:

Also, IF they did NOT receive their baptism at St. Joseph the worker of Moss Point or at St. Ann of Hurley

Please PROVIDE A COPY OF THEIR BAPTISMAL CERTIFICATE.

Special needs, food allergies? Is there anything you would like to share about your child that would help us in communicating?

Are you interested in being a parent volunteer?

Yes

Clear selection

6th- 12th grade: interested in being a member of "CYO" youth program?

Yes

Clear selection

Submit

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