Registration is now closed. If you have any questions please reach out to communion@stccc.org Parent InformationLast Name:(Required)Father’s Name(Required)Mother’s Name:(Required)Please Enter Address Below(Required) Address Number & Street Name City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific Zip Code Mother's Cell Phone #:(Required)Mother Email/Main Email (For All Communication)(Required) Mother's Email (if different from main email)Father's Cell Phone #:(Required)Father's Email(Required)Which Mass time do you prefer to participate in? (Please check one)(Required)Reminder. Mass is on April 24, 2027 10:00 am 2:00 pm Child InformationHow many children will be taking communion this year?(Required) 1 2 Child's - First Name:(Required)Child's Last Name:(Required)Child's - Date of Birth(Required) Child 1 - Grade in September(Required)What Grade is your child in as of September 2025? Accepting 3rd Graders and Up3rd Grade4th Grade5th GradeChild 1 - Gender(Required) Male Female Child #2 - First Name:(Required)Child #2 - Last Name:(Required)Child #2 - Date of Birth(Required) Child 2 - Grade in September(Required)What Grade is your child in as of September 2025? Accepting 3rd Graders and Up3rd Grade4th Grade5th GradeChild #2 - Gender(Required) Male Female Protecting God's ChildrenOur parish will be presenting a Child Abuse Prevention Program called “Protecting GODS Children” to all the children and youth enrolled in our parish programs. It is provided by St. Thomas Chaldean Diocese and is a part of our ongoing effort to help create and maintain a safe environment for children and to protect all children from sexual abuse. This educational program is mandated by the Conference of Catholic Bishops. As a parent you have a right to choose whether your child participates. If you have any question about the program you may contact your pastor. PGC Consent(Required) (YES) I give my permission to have my child participate in the “Protecting GODS Children” (NO) I decline to have my child participate in the “Protecting GODS Children” I'd Like to Discuss the Program with someone for More Information Baptism CertificateYour Child's Baptism Certificate is Required Before the Start of Classes. You May Upload Here or Provide On the First Day.Baptism File Upload (Optional) Drop files here or Select files Max. file size: 256 MB. Child 1 CostCovers the program and basic costs to the parish. Price: Child 2 CostCovers the program and basic costs to the parish. Price: If you would like to help the church out in paying the 3.5% CC fees please click YES below YES Credit Card Processing Fees Price: $6.00 Total Credit Card PaymentCredit Card Payment Information(Required) American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20262027202820292030203120322033203420352036203720382039204020412042204320442045 Security Code Cardholder Name
