Our Lady of Lourdes Church Parish Registration
Family Name
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Language Spoken at Home
*
Years at the Parish
*
Family Residence
Tenant
Owner
Head of Household
Married
Separated
Divorced
Widowed
Single
Please list only those living with you (include Last name if different)
Head of Household
*
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Religion
Sacraments Received
Baptism
1st Communion
Confirmation
School, Occupation, or Homebound
Spouse
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Religion
Sacraments Received
Baptism
1st Communion
Confirmation
School, Occupation, or Homebound
Child / Children (Please list children and include Date of birth, Religion, Sacraments Received, and School Grade)
e.g. John Smith - 01/01/24 - Catholic - Baptized - newborn
Other living with you (Please list children and include Date of birth, Religion, Sacraments Received, and School/ Occupation/ Homebound)
Would you like us to send Weekly Envelopes?
Yes
No
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