Parish Member Registration Form
Household Information
Name
Father's Last Name
Father's First and Middle Name
Name
Mother's Last Name
Mother's Last and Middle Name
Mother's Maiden Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
Marital Status
Single
Engaged
Married
Separated
Widowed
Other
Date
-
Month
-
Day
Year
Date
Name of Church Where Married
Church Name
City, State
Previous Church
Church Name
City, State
Name of Each Adult Member:
Adult Full Name
First, Middle, Last
Nickname
Date of Birth
-
Month
-
Day
Year
Date
Religion
Catholic
Other
Other Denomination (if not Catholic)
Occupation
Employer
Work Phone
Please enter a valid phone number.
Cell Phone
Please enter a valid phone number.
Preferred Email
example@example.com
2nd Adult Full Name
First, Middle, Last
Nickname
Date of Birth
-
Month
-
Day
Year
Date
Religion
Catholic
Other
Other Denomination (if not Catholic)
Occupation
Employer
Work Phone
Please enter a valid phone number.
Cell Phone
Please enter a valid phone number.
Preferred Email
example@example.com
(Family members 23 and older are encouraged to register as independent adults)
First Child's Full Name
First, Middle, Last
Gender
Male
Female
Date of Birth
-
Month
-
Day
Year
Date
Religion
Catholic
Other
Other Denomination (if not Catholic)
Sacraments
Baptism
Communion
Confirmation
Sacrament Information
*
Current Grade in School
Name of School
Second Child's Full Name
First, Middle, Last
Gender
Male
Female
Date of Birth
-
Month
-
Day
Year
Date
Religion
Catholic
Other
Other Denomination (if not Catholic)
Sacraments
Baptism
Communion
Confirmation
Sacrament Information
*
Current Grade in School
Name of School
Third Child's Full Name
First, Middle, Last
Gender
Male
Female
Date of Birth
-
Month
-
Day
Year
Date
Religion
Catholic
Other
Sacraments
Baptism
Communion
Confirmation
Sacrament Information
*
Other Denomination (if not Catholic)
Current Grade in School
Name of School
4th Child's Full Name
First, Middle, Last
Gender
Male
Female
Date of Birth
-
Month
-
Day
Year
Date
Religion
Catholic
Other
Sacraments
Baptism
Communion
Confirmation
Sacrament Information
*
Other Denomination (if not Catholic)
Current Grade in School
Name of School
Website Approval
Yes
No
It is common practice for Saint Hedwig Catholic Church to use photographs on our parish website and in parish publications. I give my consent for my child(ren) listed on this form to be photographed with the understanding that these photos may be used in parish publications including on the website.
Initials
*
Submit
Should be Empty: