ROMAN CATHOLIC FAMILY OF DAYSLAND, HEISLER, KILLAM & PARISHES
Daysland - Our Lady of the Prairies Parish * Heisler - St. Martin Parish * Killam - St. Joseph Parish
Spring Lake - St. Boniface Historical Church * Strome – St. Peter Historical Church
Polska – St. John the Baptist Church * Prague – St. John Nepomucene Church
Administration Office: ■ 5001-53 St. - Box 570 * Killam, AB * T0B 2L0 ■ Tel. (780)385-3503 * Fax (780)385-3516
Website: www.rcfamily.ca * E-mail to office: office@rcfamily.ca * E-mail to pastor: pastor@rcfamily.ca
Sacrament of First Holy Communion - Registration Form (Year ______)
Child’s FULL Legal name
First
Middle
□ Male
Last
□ Female
School
Grade
Birth Date
(mm/dd/yyyy)
□ Yes
Is your child currently taking a religion program?
□ No
Program
Mother’s FULL legal Name
(Maiden Name)
Father’s FULL legal Name
Home Mailing Address
City
Province
Home Phone Number
Work Phone Number
Email address
Parish of Baptism or Profession of Faith
City
Postal Code
Date (mm/dd/yyyy)
If your child was baptized at one of our parishes (Daysland – Heisler – Killam) you do not need to provide a copy of
Baptism Certificate. If he/she was baptized elsewhere we will need a copy of the Baptism Certificate.
Where would you like your child to receive his/her First Holy Communion?
□
□
Daysland - Our Lady of the Prairies Church
Heisler - St. Martin Church
□
Killam - St. Joseph Church
Date of filling the registration form by Parent/Guardian
Parent/Guardian Signature of Commitment
Date the registration form was received in the office