Registration

We are a family of faith-filled disciples, empowered by the Holy Spirit, living the gospel through worship and service.

Pastor Fr. John Barry

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CONFIDENTIAL

REGISTRATION FORM

 

 

New to Parish   

Leaving Parish  Address Change 

Household Title :         ( Mr. & Mrs., Mr., Mrs., Ms. )

Address:

Street    
City    
State Zip Code

 

Phone      

Family email 

 Man's               

Name
D.O.B.
Religion

           

 

Woman's

Name
D.O.B.
Religion

 

Marital Status:

Married

  Single

Widowed

Separated

Divorced

   If married, is the marriage recognized by the Catholic Church ? ( Y/N )

Children

     Name      D.O.B Baptism

(Y/N)

 Communion

(Y/N)

 Confirmation

(Y/N)

          School Name    Grade

Do school age children not attending a Catholic school attend CCD? (Y/N) 

Extended Family or others living in your Household:

     Name      D.O.B Baptism

(Y/N)

 Communion

(Y/N)

 Confirmation

(Y/N)

          School Name    Grade

 

Comments

 

                                                                               

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