Sacramental Enrolment Form 2026 – Holy Trinity Parish Queenscliff

Sacrament to be enrolled in (please tick one)(Required)

Reconciliation

1st Eucharist

Confirmation

FULL name of child(Required)

Address(Required)

Mobile number(Required)

Email(Required)

Name of person enrolling child:(Required)

Relationship to child(Required)

Child’s date of birth:(Required)

Current Age(Required)

School name(Required)

Year Level (in 2026):(Required)

Baptism date(Required)

Name of Church baptised:(Required)

Address of Church baptised(Required)

Please attach/provide a copy of your child’s baptism certificate

Accepted file types: pdf, jpg, png, jpeg, zip, Max. file size: 10 MB.

Please attach/provide a copy of your child’s other sacramental certificate(s)

Accepted file types: pdf, jpg, png, jpeg, zip, Max. file size: 10 MB.

Name of person(s) collecting child:(Required)

Mobile number(s):(Required)

Emergency contact person(Required)

Mobile number(Required)

Child’s Medicare number

Name of private health insurance

If yes, membership number

Ambulance membership

Yes

Family doctor’s name:

Family Doctor’s address:

Family doctor’s telephone number

Does your child have any medical conditions / allergies / asthma or any special needs?

Does your child have any special dietary requirements?

Is there anything that we should know about your child’s needs?

Father’s name

Mother’s name

Mother’s maiden name

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