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ST. ALBERT THE GREAT
2022-2023 CCD PROGRAM REGISTRATION
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Family Address
Primary Family Address
Are you registered members of St. Albert the Great Parish?
Yes
No
Your Parish
If no, please list the name of your parish AND if not previously submitted you must attach a letter of permission from your pastor for your child to attend St. Albert's CCD Program
Family Name
Address
This email will be used to provide you with program/calendar updates, information about upcoming program related events, student assignments, and information concerning sacramental preparation. It will serve as the primary means of communication between the program and your family.
Primary E-mail
This will be the main e-mail address we will use to communicate with your family.
Primary Phone
This will be the main phone number we will use to communicate with your family.
Number of Children (Discount Rate May 1 - May 31)
1
2
3
4
5
Number of Children you will be registering today
Number of Children
1
2
3
4
5
Number of Children you will be registering today
SCRIP Credit
If you have SCRIP Credit you would like to use, please enter the amount here. It will be deducted from your registration fees.
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Father / Guardian
Name
Deceased
Yes
No
E-mail
Marital Status
Married
Divorced
Separated
Single
Widower
Religion
Cell Phone
Mother / Guardian
Maiden Name
Name
Deceased
Yes
No
E-mail
Marital Status
Married
Divorced
Separated
Single
Widow
Religion
Cell Phone
Custody Information
Are there any custody issues we should be made aware of? Please describe here. If there is a custody agreement please upload a copy to the registration form on the child's information page.
Full name of Stepparent/Guardian
If applicable
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Child 1
Is your child a New or Returning Student to our program?
New Student
Returning Student
Name
Gender
Male
Female
Date of Birth
Place of Birth
City & State
Religious Education Grade
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
Sixth Grade
Seventh Grade
Eighth Grade
Grade in this upcoming fall
School Grade
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
Sixth Grade
Seventh Grade
Eighth Grade
School Grade this upcoming fall
School
School District
Help us provide the best faith formation possible for your child by letting us know about the special circumstances in your child's life that can have an impact in a classroom setting. Does your child receive learning support, take medication on a regular basis, have a medical condition (e.g., allergies, require an Epi-Pen, heart condition, etc.) or has your child recently experienced a life altering event (e.g., death of a family member, divorce, recent move, etc.).
Special
No
Yes
If "YES" please briefly describe
Child 1 Sacraments
Has your child received prior religious instruction?
No
Yes
Has your child received prior religious instruction?
If YES, Please provide details on WHERE and WHEN
At the end of the form please upload a copy of the baptismal certificate below for new students if not baptized at St. Albert the Great
Date of Baptism
EXACT DATE OF BAPTISM
Church of Baptism
Church Name & Mailing Address
Has your child received the sacrament of Penance?
No
Yes
Church of Penance
If "YES" at what parish?
Has your child received the sacrament of Holy Communion?
No
Yes
Church of Holy Communion
If "YES" at what parish?
Child 1 Session Choice
Child 1 Session Choice
Tuesday Afternoon 4:30 – 5:45 PM (deadline for registration September 30)
Family Catechesis Option (deadline for registration August 31)
Child 2
Is your child a New or Returning Student to our program?
New Student
Returning Student
Name
Gender
Male
Female
Date of Birth
Place of Birth
City & State
Religious Education Grade
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
Sixth Grade
Seventh Grade
Eighth Grade
Grade this upcoming fall
School Grade
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
Sixth Grade
Seventh Grade
Eighth Grade
School Grade this upcoming fall
School
School District
Help us provide the best faith formation possible for your child by letting us know about the special circumstances in your child's life that can have an impact in a classroom setting. Does your child receive learning support, take medication on a regular basis, have a medical condition (e.g., allergies, require an Epi-Pen, heart condition, etc.) or has your child recently experienced a life altering event (e.g., death of a family member, divorce, recent move, etc.).
Special
No
Yes
If "YES" please briefly describe
Child 2 Sacraments
Has your child received prior religious instruction?
No
Yes
Has your child received prior religious instruction?
If YES, Please provide details on WHERE and WHEN
At the end of the form please upload a copy of the baptismal certificate below for new students if not baptized at St. Albert the Great
Date of Baptism
EXACT DATE OF BAPTISM
Church of Baptism
Church Name & Mailing Address
Has your child received the sacrament of Penance?
No
Yes
Church of Penance
If "YES" at what parish?
Has your child received the sacrament of Holy Communion?
No
Yes
Church of Holy Communion
If "YES" at what parish?
Child 2 Session Choice
Child 2 Session Choice
Tuesday Afternoon 4:30 – 5:45 PM (deadline for registration September 30)
Family Catechesis Option (deadline for registration August 31)
Child 3
Is your child a New or Returning Student to our program?
New Student
Returning Student
Name
Gender
Male
Female
Date of Birth
Place of Birth
City & State
Religious Education Grade
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
Sixth Grade
Seventh Grade
Eighth Grade
Grade this upcoming fall
School Grade
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
Sixth Grade
Seventh Grade
Eighth Grade
School Grade this upcoming fall
School
School District
Help us provide the best faith formation possible for your child by letting us know about the special circumstances in your child's life that can have an impact in a classroom setting. Does your child receive learning support, take medication on a regular basis, have a medical condition (e.g., allergies, require an Epi-Pen, heart condition, etc.) or has your child recently experienced a life altering event (e.g., death of a family member, divorce, recent move, etc.).
Special
No
Yes
If "YES" please briefly describe
Child 3 Sacraments
Has your child received prior religious instruction?
No
Yes
Has your child received prior religious instruction?
If YES, Please provide details on WHERE and WHEN
At the end of the form please upload a copy of the baptismal certificate below for new students if not baptized at St. Albert the Great
Date of Baptism
EXACT DATE OF BAPTISM
Church of Baptism
Church Name & Mailing Address
Has your child received the sacrament of Penance?
No
Yes
Church of Penance
If "YES" at what parish?
Has your child received the sacrament of Holy Communion?
No
Yes
Church of Holy Communion
If "YES" at what parish?
Child 3 Session Choice
Child 3 Session Choice
Tuesday Afternoon 4:30 – 5:45 PM (deadline for registration September 30)
Family Catechesis Option (deadline for registration August 31)
Child 4
Is your child a New or Returning Student to our program?
New Student
Returning Student
Name
Gender
Male
Female
Date of Birth
Place of Birth
City & State
Religious Education Grade
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
Sixth Grade
Seventh Grade
Eighth Grade
Grade this upcoming fall
School Grade
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
Sixth Grade
Seventh Grade
Eighth Grade
School Grade this upcoming fall
School
School District
Help us provide the best faith formation possible for your child by letting us know about the special circumstances in your child's life that can have an impact in a classroom setting. Does your child receive learning support, take medication on a regular basis, have a medical condition (e.g., allergies, require an Epi-Pen, heart condition, etc.) or has your child recently experienced a life altering event (e.g., death of a family member, divorce, recent move, etc.).
Special
No
Yes
If "YES" please briefly describe
Child 4 Sacraments
Has your child received prior religious instruction?
No
Yes
Has your child received prior religious instruction?
If YES, Please provide details on WHERE and WHEN
At the end of the form please upload a copy of the baptismal certificate below for new students if not baptized at St. Albert the Great
Date of Baptism
EXACT DATE OF BAPTISM
Church of Baptism
Church Name & Mailing Address
Has your child received the sacrament of Penance?
No
Yes
Church of Penance
If "YES" at what parish?
Has your child received the sacrament of Holy Communion?
No
Yes
Church of Holy Communion
If "YES" at what parish?
Child 4 Session Choice
Child 4 Session Choice
Tuesday Afternoon 4:30 – 5:45 PM (deadline for registration September 30)
Family Catechesis Option (deadline for registration August 31)
Child 5
Is your child a New or Returning Student to our program?
New Student
Returning Student
Name
Gender
Male
Female
Date of Birth
Place of Birth
City & State
Religious Education Grade
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
Sixth Grade
Seventh Grade
Eighth Grade
Grade this upcoming fall
School Grade
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
Sixth Grade
Seventh Grade
Eighth Grade
School Grade this upcoming fall
School
School District
Help us provide the best faith formation possible for your child by letting us know about the special circumstances in your child's life that can have an impact in a classroom setting. Does your child receive learning support, take medication on a regular basis, have a medical condition (e.g., allergies, require an Epi-Pen, heart condition, etc.) or has your child recently experienced a life altering event (e.g., death of a family member, divorce, recent move, etc.).
Special
No
Yes
If "YES" please briefly describe
Child 5 Sacraments
Has your child received prior religious instruction?
No
Yes
Has your child received prior religious instruction?
If YES, Please provide details on WHERE and WHEN
At the end of the form please upload a copy of the baptismal certificate below for new students if not baptized at St. Albert the Great
Date of Baptism
EXACT DATE OF BAPTISM
Church of Baptism
Church Name & Mailing Address
Has your child received the sacrament of Penance?
No
Yes
Church of Penance
If "YES" at what parish?
Has your child received the sacrament of Holy Communion?
No
Yes
Church of Holy Communion
If "YES" at what parish?
Child 5 Session Choice
Child 5 Session Choice
Tuesday Afternoon 4:30 – 5:45 PM (deadline for registration September 30)
Family Catechesis Option (deadline for registration August 31)
Document Uploads
File Upload
Add files
Drop files anywhere to add
Please upload any documents required by the office with this form. (Baptism, Custody, etc.)
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Immunization
Are all of your child(ren)s vaccinations up to date?
Yes
No
If no, have they received an exemption from your current school district?
Yes
No
If no, please explain
Emergency Contact
Emergency Contact Name
If we are unable to contact a parent in the event of an emergency, whom should we contact?
Relationship
Emergency Contact Phone 1
Emergency Contact Phone 2
Volunteer Information
Will you be volunteering?
Yes
No
Volunteer Name
Volunteer Phone
Volunteer Interested in
Teacher
Assistant Teacher
Hall Monitor
Terms & Conditions
I give permission that, in my absence, my children whose name appears on this form, may receive emergency medical care for injuries and all situations that should occur while participating in the CCD Program and activities at St. Albert the Great Parish.
Yes
Do you grant permission for your child’s picture to appear on our parish website, bulletin boards, newspaper articles, and/or any social media in relation to events that occur as part of his or her enrollment in CCD? No names will be used to identify children in photo related material.
Yes
No
Total Cap
Sacramental Fees
Late Fee
Current Date
Total Normal
Fees are due in full at the time of registration. Forms submitted with missing fees or documentation will be returned unprocessed.
Total Amount
Verification
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SUBMIT FORM AND PAY