Registration Form

Name of Candidate: ____________________________________________________________________________ First Middle Last

Home Address: ________________________________________________________________________________

Name of School: ____________________________________ Teacher: _______________________ Grade: ______

Date of Birth: ________________________________ Place of Birth: (City) ________________________________

Are you Baptized Catholic: Yes: ___ No: ___ Date of Catholic Baptism: __________________________________

Name of Church of Catholic Baptism: ______________________________________________________________

Baptism Certificate Attached: Yes: __ No: __ Note: If Catholic Baptism took place at St. Brigid’s Church, we can locate the details.

Have you received First Reconciliation: Yes: ___ No: ___ Have you received First Communion: Yes: __ No: __

Does your child have any special needs? ____________________________________________________________

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Father’s or Guardian’s Name: (First) __________________________ (Surname) ____________________________

Contact Number: ________________________ Email Address:__________________________________________

Signature: ____________________________________

Mother’s or Guardian’s Name: (First) _______________________ (Maiden Name) __________________________

Contact Number: ________________________ Email Address: _________________________________________

Signature: ____________________________________

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Sponsor’s Name :_______________________________________________________________________________ First Middle Last

If the Sponsor was confirmed at St. Brigid’s Church or St. Catherine of Siena please indicate the year: ___________

The sponsor must provide a copy of their Confirmation certificate unless they were confirmed at St. Brigid’s or St. Catherine of Siena Church.

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In Case of Emergency:

Name: _______________________________________ Number: ________________________________________

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Registration fee $50.00: Paid by: Cash: ____ Cheque: ____ Date Received: _____________________________

300 Wolverleigh Blvd. Toronto, ON M4C 1S6 Tel: 416-696-8660 Fax: 416-425-7602 Email: stbrigid@rogers.com www.stbrigids.archtoronto.org