Registration Form for 6th-12th Grade

Head of Household

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.
Street Address REQUIRED Please fill out this field. Please enter valid data.
City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.
Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
Email REQUIRED Please fill out this field. Please enter an email address.

Marital Status of Parents:

Child resides with:

Contact Phone Number REQUIRED Please fill out this field. Please enter a phone number.

A Baptism Certificate must be submitted for children preparing to receive Confirmation.

THE FOLLOWING STATEMENT MUST BE CHECKED BY A PARENT OR LEGAL GUARDIAN:

In the event of a health emergency that requires immediate medical attention, I give permission to transport my child to a hospital for emergency treatment. I wish to be advised prior to any further treatment by the hospital or doctor.

I Agree Please select this field.

Date REQUIRED Please fill out this field. Please enter a date.

Holy Family Catholic Church

Abilene, TX

Registration Form for 6th-12th Grade