[[[["field15","equal_to","Engaged"]],[["show_fields","field22"]],"and"],[[["field15","equal_to","Married"],["field15","equal_to","Married with kids"]],[["show_fields","field21"]],"or"],[[["field15","equal_to","Engaged"],["field15","equal_to","Married"],["field15","equal_to","Married with kids"]],[["show_fields","field23,field24,field25,field26,field27,field28,field29,field30,field31"]],"or"],[[["field15","equal_to","It's complicated..."]],[["show_fields","field64"]],"and"],[[["field15","equal_to","Married with kids"],["field15","equal_to","Single Parent"],["field64","equal_to","Yes"]],[["show_fields","field32,field66,field33"]],"or"],[[["field33","greater_than","0"]],[["show_fields","field38,field37,field36,field35"]],"and"],[[["field33","greater_than","1"]],[["show_fields","field39,field40,field41,field42"]],"and"],[[["field33","greater_than","2"]],[["show_fields","field43,field44,field45,field46"]],"and"],[[["field33","greater_than","3"]],[["show_fields","field47,field48,field49,field50"]],"and"],[[["field33","greater_than","4"]],[["show_fields","field59"]],"and"],[[["field73","contains"]],[[]],"and"]]
1 Step 1
CLCC Household Information Form
Family Surname
I / We Attend:
Household Contact Information
Street Address
Postal Code
AddressPublish in Directory?
Home Phone(If applicable, do not list cell numbers here)
Home PhonePublish in Directory?
Upload a current photo for CLCC's Photo Directory!
My Information

*The Canada Revenue Agency requires Middle Initials for donation tax receipts.

My First Name (Legal)
My Last Name
Please Note:
Preferred Name (if applicable)
My Gender
My Marriage / Family Status
Do you have kids?
My Birthdate(For our records only)
My Cell Phone(If applicable)
My CellPublish in Directory?
My EmailPublish in Directory?
Would you like to receive important email reminders from CLCC?As part of our goal to "go paperless" we would love to be able to send you important and applicable emails. Rest assured we hate SPAM as much as you! If you find that these emails are bothersome you will be able to unsubscribe from this list at any time..
My Spouse's Information
My Future Spouse's Information
Spouse's First Name
Spouse's Last Name
My Spouse:
Spouse's Birthdate(For our records only)
Spouse's Cell Phone(If applicable)
Spouse's CellPublish in Directory?
Spouse's EmailPublish in Directory?
My Kids' Information

If you have adult children (18+) that attend CLCC,
please encourage them to fill out their own form.

Number of Children(Under 18 who live at home)

Please enter the your children's information starting with the oldest child.

Child's Name(First and Last)
Birthdate(For our records only
Child's Name(First and Last)
Birthdate(For our records only
Child's Name(First and Last)
Birthdate(For our records only
Child's Name(First and Last)
Birthdate(For our records only
5+ Children at Home?If you have more than 4 children that currently live at home, please list the remaining children here (oldest to youngest). Please include their name, gender and birthdate.
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Thanks for taking the time to fill out your information!

Don't forget to submit a signed hard copy of the CLCC Consent Form to give us permission to publish your contact information in our Photo Directory.  You can download one HERE.