New Member Form

Name *

First

Last

City *

State *

E-mail *

Phone *

Parish Name and Location (city) *

Diocese *

Is your family currently homeschooling? *

Yes
No
Considering

How did you hear about CRECHE? *

CRECHE follows the Rockford Diocese's Safe Environment requirements. Do you have an active and updated VIRTUS online account with the Rockford Diocese? *

Yes, I do
No, I do not

CRECHE is a member group of HSLDA. Is your family currently a member of HSLDA? *

Yes
No
Considering

CRECHE is a Catholic Apostolate (an association of persons dedicated to the propagation of a religion or a doctrine), and an all-volunteer organization. All of our activities require parental involvement and supervision. Will you be able to participate with your children at CRECHE activities or events? *

Yes
No

If you will not be able to participate at CRECHE activities or events, please explain:

How many children do you have and what are their ages? *

Comment or Message

New Member Membership Request

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