Saturday, August 18, 2018 at 12:51 PM
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Parish Registration

Thanks for taking a moment to register your household's information with our parish's office. Please fill out the form as completely as possible and then click submit.

I am Registering for:
Church
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Demographic Information
Status
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Name of Head of Household
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Head of Household Female or Male
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Birth Date of Head of Household //
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Religion of Head of Household
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Name of Spouse
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if applicable
Spouse: Female or Male
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Birthdate of Spouse //
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Religion of Spouse
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First and Last Name(s) of Other Adult(s) in Household
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Child 1 Name
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Child 1 Date of Birth //
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Child 1 Male or Female
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Child 2 Name
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Child 2 Date of Birth //
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Child 2 Male or Female
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Child 3 Name
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Child 3 Date of Birth //
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Child 3 Male or Female
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Child 4 Name
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Child 4 Date of Birth //
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Child 4 Male or Female
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Additional Children: Name, Birth Date and Male or Female
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Primary Phone --
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Secondary Phone --
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Email Address
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Alternative Email Address
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Home Address
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Would you like to use offertory envelopes?
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Is this information:
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Spam Capture
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