PrivateComm

Parent Information

Last Name:(Required)

Father’s Name(Required)

Mother’s Name:(Required)

Please Enter Address Below(Required)

Address Number & Street Name City State 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 May 3 2025

10:00 am

2:00 pm

Child Information

How many children will be taking communion this year?(Required)

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 2023? Accepting 3rd Graders and Up

Child 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 2023? Accepting 3rd Graders and Up

Child #2 - Gender(Required)

Male

Female

Protecting God's Children

Our 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.

(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 Certificate

Your 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

Max. file size: 32 MB.

Child 1 Cost

Covers the program and basic costs to the parish.

Price:

Child 2 Cost

Covers 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 Payment

Credit Card Payment Information(Required)

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

Donate Here

Parish Info

Parish Info

Donate Here

PrivateComm

PrivateComm

Parent Information

Child Information

Protecting God's Children

Baptism Certificate

Credit Card Payment