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Parish Registration Form

* Required field
Please check one:*:
I am a new registrantPlease update my information
Household Adult 1*:
Household Adult 2:
Please check one::
SingleMarriedDivorcedWidowed
Address*:
City*:
State*:
Zip*:
Primary Phone*:
Secondary Phone:
Primary Contact Email:
Household Adult 1
Date of Birth:
Gender:
MaleFemale
Religion:
Baptized:
YesNo
Confirmed:
YesNo
Occupation:
Email:
Household Adult 2
Date of Birth:
Gender:
MaleFemale
Religion:
Baptized:
YesNo
Confirmed:
YesNo
Occupation:
Email:
Place of Marriage
City/State:
Date:
Parish:
Family Information
Please list the name and date of birth for all family members under the age of 21 living at home. If possible, list where and when the sacraments of baptism, first communion and confirmation were received.
Family:
Verification
Verification:
Captcha