First Eucharist and Communion – Holy Redeemer Roman Catholic Church

Full Legal Name of Person Doing First Eucharist (Communion)

Date of Birth (month, day, year)

Place of Birth (city and province)

Father's First and Last Name

Mother's First Name and Maiden Name

Address (street name and house number, city, province)

School and Grade

Church, City & Province where Child was baptised (We will need a copy of the baptism certificate at a later date if not baptized at Holy Redeemer Roman Catholic Church.)

Date of Baptism (month, day, year)

Church, City & Province where Child received First Reconciliation

Date of First Reconciliation (month, day, year)

Our family normally worships at

My child currently lives on most days with

Home Phone Number

Cell Phone Number

Prefers calls to

home phone

cell phone

During the

Day

Evening

Contact Person's Name

Contact Person's Email Address

Please list any learning disabilities: