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PARISH REGISTRATION

Gender
Male
Female
Date of Birth
Month
Day
Year
Sacraments Received
Marital Status
Single
Married
Widowed
Separated
Divorced
Catholic Marriage
Yes
No
Date of Marriage
Month
Day
Year
Gender
Male
Female
Date of Birth
Month
Day
Year
Sacraments Received
How many children do you have (age 20 and under ONLY)?

Independent children, older than 21, please register separately.

May we publish your information in our directories?

Publish Adult/Parent Name(s)
Publish Address
Publish Primary Phone
Publish Children's Names

Additional Information

Would you like to receive offertory envelopes?
Yes
No
Is there anyone who is homebound?
Yes
No
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