Todays date Student Name (First, Middle, and Last) * Check which program this student is registering for: Pre-First Communion Program (1st Grade) First Communion Program (2nd Grade) CCD Program (Post First Communion - 3rd Grade to 8th Grade) Confirmation Program (this is a two-year program - 9th & 10th Grade ) For New Students in First Communion Class, a copy of your child's Baptismal Certificate is required. If you are unable to find a certificate, please contact the church where your child was baptized. If you have any questions or concerns, please contact Fr. Scott Allen at firstname.lastname@example.org If your child has already received First Communion and First Penance (Confession), please indicate Church name and date: Date of Birth* Your child is:DeafHard of HearingCODA (Child of a Deaf Adult) - hearing Mother's Name: Maiden Name: Father's Name:* Home Address (number, street, city and zip code) Video Phone Number: Home Phone Number Cell Phone No Does your SmartPhone number have text messaging?YesNo Email Address:* Emergency Contact - In case of emergency, who should we contact if we can not reach the parents listed above: (please provide a phone number and indicate smartphone or home phone or video phone): School Currently Attended By Child: Current Grade: Special Needs - does this child have any other special needs or medical condition that we need to be aware of? The Catholic Deaf ministry in the Diocese of Orange is funded by the pastoral services appeal. We are grateful for your continuous financial support.