Family Information
Family Last Name*
*
Street Address*
*
City*
*
State*
*
Please Select
Colorado
Zip Code*
*
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Phone Number
Please enter a valid phone number.
Head of Household
Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Sex/Gender
*
Select Your Sex/Gender
Male
Female
Email*
*
Marital Status*
*
Marital Status
Married
Single
Widowed
Divorced
Catholic Wedding?
Catholic Wedding?
Yes
No
Religion
*
What is your religion?
Catholic
Protestant
Jewish
Muslim
Atheist
Agnostic
Other
If other please specify:
Sacraments Completed?
Baptism
Confirmation
First Communion
Spouse Phone
Please enter a valid phone number.
Spouse
Name
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Spouse Email
Spouse Religion
What is your religion?
Catholic
Protestant
Jewish
Muslim
Atheist
Agnostic
Other
Sacraments Completed?
Baptism
Confirmation
First Communion
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Children (under the age of 22)
Please Select
0
1
2
3
4
5
6
7
8
9
If your children are living at home and are 21 years old or younger, please provide their information below. If they are 22 or over and reside at your address, please have them register as their own family.
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Children
Child 1
Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Gender
*
Male/Female
Male
Female
Sacraments Completed?
Baptism
Confirmation
First Communion
Grade in School
Please Select
Pre-K
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
College
If they are in school what grade are they in?
Child 2
Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Gender
*
Male/Female
Male
Female
Sacraments Completed?
Baptism
Confirmation
First Communion
Grade in School
Please Select
Pre-K
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
College
If they are in school what grade are they in?
Child 3
Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Gender
*
Male/Female
Male
Female
Sacraments Completed?
Baptism
Confirmation
First Communion
Grade in School
Please Select
Pre-K
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
College
If they are in school what grade are they in?
Child 4
Name
*
First Name
Last Name
Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Gender
*
Male/Female
Male
Female
Sacraments Completed?
Baptism
Confirmation
First Communion
Grade in School
Please Select
Pre-K
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
College
If they are in school what grade are they in?
Date of Birth
*
-
Month
-
Day
Year
Date
Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Gender
*
Male/Female
Male
Female
Sacraments Completed?
Baptism
Confirmation
First Communion
Grade in School
Please Select
Pre-K
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
College
If they are in school what grade are they in?
Gender
*
Male/Female
Male
Female
Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Gender
*
Male/Female
Male
Female
Sacraments Completed?
Baptism
Confirmation
First Communion
Grade in School
Please Select
Pre-K
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
College
If they are in school what grade are they in?
Sacraments Completed?
Baptism
Confirmation
First Communion
Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Gender
*
Male/Female
Male
Female
Sacraments Completed?
Baptism
Confirmation
First Communion
Grade in School
Please Select
Pre-K
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
College
If they are in school what grade are they in?
Grade in School
Please Select
Pre-K
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
College
If they are in school what grade are they in?
Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Gender
*
Male/Female
Male
Female
Sacraments Completed?
Baptism
Confirmation
First Communion
Grade in School
Please Select
Pre-K
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
College
If they are in school what grade are they in?
Child 5
Child 6
Tithing Preference
Child 7
Child 8
Communications
Outside of our weekly bulletin, we use email and text message to communicate with our parishioners about what is happening at the parish through a service called Flocknote. Is it okay to email or text? Select both if you're ok with either, or choose your preferred communication method. We don't share your contact information with anyone outside of the parish.
Child 9
CONFIRMATION AND SUBMISSION
By hitting the Submit button, you agree to share your information with Immaculate Heart of Mary Catholic Parish for the purposes of registering as a parishioner. Your information is secure, and won't be shared with anyone outside of the parish. If you agree, select the I Agree checkbox and choose Submit when you're done.
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Giving: Envelope or Online/Automatic
Envelope
Online/Automatic
Interested in Volunteering?
Yes. Please contact me!
Flocknote Communications
Text
Email
Confirmation*
*
I Agree
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