Online Registration Form for Reconciliation and Communion - Our Lady of Perpetual Help Church

First Reconciliations and First Communion

Our Lady of Perpetual Help Church 2022 Registration Form
Please note it is suggested that you use a computer or laptop to fill out this form as phone submissions do not always work.
Child's Information
Name *

First Name Middle Name Last Name
Male Female
Birthday *

Month Day Year
Date
Religion *
What school does your child attend? *
What Grade is your Child in? *
Child resides with both Parents?

Yes No
If No which Parent does the Child reside with?
Address of Child *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
My Child was Baptized at OLPH Church - if other please provide Church and Date

Yes No
Please upload a picture of your Child's Baptist Certificate - if not at OLPH Church *please note you still maybe required to bring a copy in if picture is not able to be clearly read.*
Parent's Information
Father's Name

First Name Last Name
Phone Number

Area Code Phone Number
Mother's Name

First Name Last Name
Mother's Maiden name (if applicable)
Phone Number

Area Code Phone Number
Primary E-mail to use for Communication
example@example.com
Please note this email address will be used for updates to the program and important communications, consider using one that you check often. All communcations will come from a Diocese of London email address.
Please advise if there are any special needs, we should be aware of concerning your child?
Media Release I UNDERSTAND THAT Our Lady of Perpetual Help Church COLLECTS, RECORDS, PUBLISHES, POSTS, TRANSMITS AND DISPLAYS AUDIO/VISUAL "MEDIA" (IMAGES, RECORDINGS, VIDEOS AND OTHER MEDIA) TO FURTHER THE MINISTRY PURPOSES OF THE CHURCH. THIS APPLIES TO ALL MEDIA DISPLAYED PUBLICLY, ON THE CHURCH WEBSITE, VIA EMAILS OR IN ANY WAY MADE AVAILABLE TO VIEWING OR LISTENING BY THE CHURCH GENERAL PUBLIC. i UNDERSTAND THAT ALL MEDIA REMAINS PROPERTY OF Our Lady of Perpetual Help Church. I AGREE. *

Yes No
I will be paying the $45.00 Registration Fee this way:

I will send an e-Transfer for $45 to olph@dol.ca with First Reconciliation/Communion 2022 in the memo line (no password needed). I will be placing and Envelope labelled First Reconciliation/Communion 2022 in the Offertory Basket at a Weekend Mass. I will be mailing a cheque/money order to Our Lady of Perpetual Help Parish (Attention Christine Toffolon.) I would like to make an appointment to pay cash. I would like to discuss financial assistance.
*e-Transfer is the preffered method of payment at this time.

Please note you will be contacted in Janurary 2022 with further details. Keep in mind classes will be on Wednesday nights from 6:30 to 8:00 pm. We are planning for in person classes at OLPH Parish.
Should be Empty:

Now create your own Jotform - It's free! Create your own Jotform

First Reconciliations and First Communion

Child's Information

Parent's Information

Please note you will be contacted in Janurary 2022 with further details. Keep in mind classes will be on Wednesday nights from 6:30 to 8:00 pm. We are planning for in person classes at OLPH Parish.