First Reconciliation and Confession - Holy Redeemer Roman Catholic Church

Full Legal Name of Person Doing First Reconciliation

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)

Our family normally worships at

My child currently lives on most days with

Home Phone Number

Cell Phone Number

Prefer calls to

Home Number

Cell Number

During the

day

evening

Contact Person's Name

Contact Person's E-mail Address

Please list any learning disabilities: