Parish Registration – St. Mary's Catholic Church

Date

Family Name

Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Head of Household

Birthday

Primary Phone

Cell Phone

Email

Baptized

Confirmed

Occupation / Employer

Spouse

Catholic First Last Maiden Date of Marriage

Birthday

Cell Phone

Email

Baptized

Confirmed

Occupation / Employer

Children & Dependents

Name

Birthdate

Male/Female?

Male
Female

Catholic Date of Baptism Church and City of Baptism First Communion Confirmation

Name

Birthdate

Male/Female?

Male
Female

Catholic Date of Baptism Church and City of Baptism First Communion Confirmation

Name

Birthdate

Male/Female?

Male
Female

Catholic Date of Baptism Church and City of Baptism First Communion

Name

Birthdate

Male/Female?

Male
Female

Catholic Date of Baptism Church and City of Baptism First Communion

Name

Birthdate

Male/Female?

Male
Female

Catholic Date of Baptism Church and City of Baptism First Communion

Name

Birthdate

Male/Female?

Male
Female

Catholic Date of Baptism Church and City of Baptism First Communion

Special Requests or Needs

Consent

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