First Communion registration private Please choose your mass time(Required) Mass A (10am) Mass B is now FULL. There is only the Mass A option available. Number of Kids taking communion(Required)Select Number of Kids Below12345Please check the box below that you agree to the mass time that you chose above(Required) Yes I agree to the mass time that I chose above First Child1st Child Name(Required) First Middle Initial Last Date of Birth(Required) MM slash DD slash YYYY Gender(Required) Male Female Does your child have any allergies?(Required) None Yes Please List Allergies Below(Required)Does your child require any special attention?(Required) Yes No Please List Below(Required)Does your child have any medical conditions that we need to be made aware of?(Required) Yes No Please List Below(Required)1st Child Birth Certificate(Required)Max. file size: 300 MB.1st Child Photo(Required)Max. file size: 300 MB.Child's Grade(Required)3rd Grade4th Grade5th Grade+Second Child2nd Child Name(Required) First Middle Initial Last Date of Birth(Required) MM slash DD slash YYYY Gender(Required) Male Female Does your child have any allergies?(Required) None Yes Please List Allergies Below(Required)Does your child require any special attention?(Required) Yes No Please List Below(Required)Does your child have any medical conditions that we need to be made aware of?(Required) Yes No Please List Below(Required)2nd Child Birth Certificate(Required)Max. file size: 300 MB.2nd Child Photo(Required)Max. file size: 300 MB.Child's Grade(Required)3rd Grade4th Garde5th Grade+Third Child3rd Child Name(Required) First Middle Initial Last Date of Birth(Required) MM slash DD slash YYYY Gender(Required) Male Female Does your child have any allergies?(Required) None Yes Please List Allergies Below(Required)Does your child require any special attention?(Required) Yes No Please List Below(Required)Does your child have any medical conditions that we need to be made aware of?(Required) Yes No Please List Below(Required)3rd Child Birth Certificate(Required)Max. file size: 300 MB.3rd Child Photo(Required)Max. file size: 300 MB.Child's Grade(Required)3rd Grade4th Grade5 Grade+Fourth Child4th Child Name(Required) First Middle Initial Last Date of Birth(Required) MM slash DD slash YYYY Gender(Required) Male Female Does your child have any allergies?(Required) None Yes Please List Allergies Below(Required)Does your child require any special attention?(Required) None Yes Please List Below(Required)Does your child have any medical conditions that we need to be made aware of?(Required) None Yes Please List Below(Required)4th Child Birth Certificate(Required)Max. file size: 300 MB.4th Child Photo(Required)Max. file size: 300 MB.Child's Grade(Required)3rd Grade4th Grade5 Grade+Fifth Child5th Child Name(Required) First Middle Initial Last Date of Birth(Required) MM slash DD slash YYYY Gender(Required) Male Female Does your child have any allergies?(Required) None Yes Please List Allergies Below(Required)Does your child require any special attention?(Required) None Yes Please List Below(Required)Does your child have any medical conditions that we need to be made aware of?(Required) None Yes Please List Below(Required)5th Child Birth Certificate(Required)Max. file size: 300 MB.5th Child Photo(Required)Max. file size: 300 MB.Child's Grade(Required)3rd Grade4th Grade5 Grade+Parent InformationParent Email for Updates(Required) Child's Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Father's Legal Name(Required) First Last Father's Cell Phone(Required)Father's Email(Required) Mother's Legal Name(Required) First Last Mother's Cell Phone(Required)Mother's Email(Required) If you're 18 or older, would you like to volunteer? Yes Emergency ContactsName 1(Required) First Last Phone(Required)Name 2(Required) First Last Phone(Required)Name 3(Required) First Last Phone(Required)ConsentsConsent(Required) I agreeI give permission for my child to attend the “Touch Safety Program” , I also consent to and authorize St. George Chaldean Catholic Church and it’s representatives to publish photographs, video, audio, and other media of my child that my promote the Church’s programs. Attendance Policy(Required) I agreeI understand that if my child or children have more than 3 unexcused absences they will not receive their First Holy CommunionClass Room Rules(Required) I agreeParents are not to enter the main Church or any of the classrooms during classes. I Understand(Required) I agreeI will be at the Church at 5 PM to pick up my child or children and the church is not responsible for students past 5 PM. CouponTotal Credit Card American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20252026202720282029203020312032203320342035203620372038203920402041204220432044 Security Code Cardholder Name
