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First Reconciliation & First Eucharist Track Registration

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  Child's Full FIRST Name REQUIRED Please fill out this field. Please enter valid data.
  
  Child's MIDDLE Name REQUIRED Please fill out this field. Please enter valid data.
  
  Child's LAST Name REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Age REQUIRED Please fill out this field. Please enter an integer (number).
  
  Child's DATE of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Child's CITY of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Child's STATE of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Date of Baptism REQUIRED Please fill out this field. Please enter a date.
  
  PLEASE NOTE: All parents must submit a paper copy of their child's baptismal certificate. The only exception is for children who were baptized at Archangel Gabriel Parish AFTER January 6, 2020.
  
  Child's Church of Baptism 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.
  
  Please select the entity from which your child receives his/her regular religious instruction: REQUIRED Please fill out this field.
  
  Mother's FIRST Name REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's MIDDLE Name REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's LAST Name REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's MAIDEN Name REQUIRED Please fill out this field. Please enter valid data.
  
  Father's FIRST Name REQUIRED Please fill out this field. Please enter valid data.
  
  Father's MIDDLE Name REQUIRED Please fill out this field. Please enter valid data.
  
  Father's LAST Name REQUIRED Please fill out this field. Please enter valid data.
  
  Home 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.
  
  Parent Phone Number REQUIRED Please fill out this field. Please enter valid data.
  
  Email of parent/guardian completing this form REQUIRED Please fill out this field. Please enter an email address.
  
  If you would like an additional parent/guardian to also receive updates regarding First Reconciliation and First Eucharist, please enter their email address below.
  
  Email Please enter an email address.
  
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