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Participant Registration

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St. Gertrude Catholic Church

Location

1120 S. 8th Street

Kingsville, TX 78363

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Contact Deacon Ruben Soliz Jr.:

361-592-7351

dcnrubensolizjr@gmail.com

First, Tell Us About Yourself:

Parent Information

Please complete this top section with Parent/Guardian information. There is a section below for student information.

First Name

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Last Name

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Parent 2 First Name

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Parent 2 Last Name

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Mother's Maiden Name

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Address 1

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Address 2

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City

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State/Province

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ZIP/Postal Code

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Contact Phone 1

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Contact Phone 2

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Emergency Contact Name

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Emergency Contact Relationship

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Emergency Contact Phone

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Tell Us About Your Participant

FIRST COMMUNION STUDENTS: You are required to turn in a copy of your Baptismal Certificate. You can turn in a copy to your teacher or email a copy to the church office at: stgckingsville@gmail.com

CONFIRMATION STUDENTS: You are required to turn in a copy of your Baptismal Certificate and First Communion Certificate. You can turn in copies to your teacher or email copies to the church office at: stgckingsville@gmail.com

Your teacher will provide a sponsor form to you when class starts. You will also be required to turn in your completed sponsor form.

First Name

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Middle Name

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Last Name

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Current Grade

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Gender

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Date Of Birth

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Allergies

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Medical Concerns

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Comments

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Has student been baptized?

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Name of church where baptized? Also include city, state of church

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Date of baptism?

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Has student received First Communion?

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Name of church where student received First Communion? Also include city, state of church

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Date of First Communion?

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Has student been Confirmed?

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Date of Confirmation?

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I give consent for St. Gertrude's Church staff or volunteers to photograph my child for religious education or church promotional purposes.

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