Parish Registration Form

Head of Household

Head of Household*

Male
Female

Head of Household: Date of Birth*

Head of Household: Marital Status*

Head of Household: Religion*

Received the Sacrament of Baptism?*

Yes
No

Received the Sacrament of Communion?*

Yes
No

Received the Sacrament of Confirmation?*

Yes
No

Spouse / Significant Other

Male
Female

Spouse / Significant Other: Date of Birth

Spouse / Significant Other: Marital Status

Spouse / Significant Other: Religion

Received the Sacrament of Baptism?

Yes
No

Received the Sacrament of Communion?

Yes
No

Received the Sacrament of Confirmation?

Yes
No

If Married, Wife’s Maiden Name

Married by a Catholic Priest?

Yes
No

Date of Marriage, if Married by Catholic Priest

Family Information*

Home Phone No.

Cell Phone No.*

Email*

Children / Family Members

CAPTCHA

Family Members

First Name

Last Name

Marital Status

Religion

Date of Birth

Sex

Male
Female

Received the Sacrament of Baptism

Yes
No

Received the Sacrament of First Communion

Yes
No

Received the Sacrament of Confirmation

Yes
No

Head of Household

Spouse / Significant Other

Children / Family Members

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