• ON-LINE REGISTRATION FORM

• The maximum number of form submissions has been reached. This form is currently not available.

  • Choose Day REQUIRED Tuesday (4:00 - 5:15 P.M.) Sunday (8:30 - 9:45 A.M.) Please fill out this field.
  • Registration Fees REQUIRED Registered Parishioner 1 Child: $250 Registered Parishioner 2 or More Children: $300 Max Non- Registered Parishioner 1 Child: $350 Non- Registered Parishioner 2 Children: $400 Non- Registered Parishioner 3 Children: $450 Non- Registered Parishioner 4 Children: $500 Registered Parishioner Kindergarten Only: $100 Non-Registered Parishioner Kindergarten Only: $150 Please fill out this field.

  • PARENT/GUARDIAN INFORMATION

  • • Mother's Name REQUIRED Please fill out this field. Please enter valid data.
    • Mother's Religion REQUIRED Please fill out this field. Please enter valid data.
    • Father's Name REQUIRED Please fill out this field. Please enter valid data.
    • Father's Religion REQUIRED Please fill out this field. Please enter valid data.
    • Mailing Address REQUIRED Please fill out this field. Please enter valid data.
    • City REQUIRED Please fill out this field. Please enter valid data.

      State REQUIRED AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MH MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR PW RI SC SD TN TX UT VA VI VT WA WI WV WY Please fill out this field.

      Zip REQUIRED Please fill out this field. Please enter a zip code.
    • Home Phone Number REQUIRED Please fill out this field. Please enter a phone number.
    • Email REQUIRED Please fill out this field. Please enter an email address.
    • Mother's Cell REQUIRED Please fill out this field. Please enter a phone number.
    • Mother's Address (if different from above) Please enter valid data.
    • Father's Cell REQUIRED Please fill out this field. Please enter a phone number.
    • Father's Address (if different from above) Please enter valid data.
  • • Please Enter the Number of Students you are Registering REQUIRED Please fill out this field.
    • Student 1
      • First Name REQUIRED Please fill out this field. Please enter valid data.

        Last Name REQUIRED Please fill out this field. Please enter valid data.
      • Date of Birth REQUIRED Please fill out this field. Please enter a date.
      • Grade Registering for CCD REQUIRED Please fill out this field. Please enter valid data.
      • Public School Attending REQUIRED Please fill out this field. Please enter valid data.
      • Grade in September 2020 REQUIRED Please fill out this field. Please enter valid data.
      • Sacraments Received Baptism Reconciliation Communion
      • Please list Church where Sacraments were received. If other than OLC, provide copy of certificates. REQUIRED Please fill out this field. Please enter valid data.
      • Please List any Special Needs
      • Please List any Allergies
    • Student 2
      • First Name REQUIRED Please fill out this field. Please enter valid data.

        Last Name REQUIRED Please fill out this field. Please enter valid data.
      • Date of Birth REQUIRED Please fill out this field. Please enter a date.
      • Grade Registering for CCD REQUIRED Please fill out this field. Please enter valid data.
      • Public School Attending REQUIRED Please fill out this field. Please enter valid data.
      • Grade in September 2020 REQUIRED Please fill out this field. Please enter valid data.
      • Sacraments Received Baptism Reconciliation Communion
      • Please list Church where Sacraments were received. If other than OLC, provide copy of certificates. REQUIRED Please fill out this field. Please enter valid data.
      • Please List any Special Needs
      • Please List any Allergies
    • Student 3
      • First Name REQUIRED Please fill out this field. Please enter valid data.

        Last Name REQUIRED Please fill out this field. Please enter valid data.
      • Date of Birth REQUIRED Please fill out this field. Please enter a date.
      • Grade Registering for CCD REQUIRED Please fill out this field. Please enter valid data.
      • Public School Attending REQUIRED Please fill out this field. Please enter valid data.
      • Grade in September 2020 REQUIRED Please fill out this field. Please enter valid data.
      • Sacraments Received Baptism Reconciliation Communion
      • Please list Church where Sacraments were received. If other than OLC, provide copy of certificates. REQUIRED Please fill out this field. Please enter valid data.
      • Please List any Special Needs
      • Please List any Allergies
    • Student 4
      • First Name REQUIRED Please fill out this field. Please enter valid data.

        Last Name REQUIRED Please fill out this field. Please enter valid data.
      • Date of Birth REQUIRED Please fill out this field. Please enter a date.
      • Grade Registering for CCD REQUIRED Please fill out this field. Please enter valid data.
      • Public School Attending REQUIRED Please fill out this field. Please enter valid data.
      • Grade in September 2020 REQUIRED Please fill out this field. Please enter valid data.
      • Sacraments Received Baptism Reconciliation Communion
      • Please list Church where Sacraments were received. If other than OLC, provide copy of certificates. REQUIRED Please fill out this field. Please enter valid data.
      • Please List any Special Needs
      • Please List any Allergies
  • As you are aware, we are always in need of Catechists, Aides and Substitutes for our program. If you are able to help or would like information in any of these areas, please contact Debbie Dericks at 973-839-2428 or d.dericks@olcchurch.com.
  • Permission for Child to be photographed for publicity/presentations. REQUIRED YES NO Please fill out this field.
  • • Questions/Comments

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