Directory Form

1
Head of Household* This field is required.
2
Second Head of Household (Spouse)
3
All additional family members (oldest to youngest)
4
Cell Phone Number (1)
Area Code
Phone Number
5
Cell Phone Number (2)
Area Code
Phone Number
6
Home Phone Number
Area Code
Phone Number
7
Your Email Address (1)
8
Your Email Address (2)
9
Would you like these items in the Saint Raphael Directory?Please check which item you would like in the 2025 Directory. (Email, Cell Phone, Home Phone, Photo Release)
Yes, Please include my email address in the back of the Directory
Yes, Please include my home phone in the back of the Directory
Yes, Please include my cell phone in the back of the Directory
Yes, Please include my photo in the Saint Raphael Directory. I grant the following rights to Saint Raphael Catholic Church in Crystal and Saint Raphael Catholic School and the Archdiocese of Saint Paul and Minneapolis: AUTHORIZATION, CONSENT AND RELEASE FOR USE OF VISUAL LIKENESSES AND ORIGINAL WORKS I grant the following rights toThe Church of Saint Raphael and the Archdiocese of Saint Paul and Minneapolis: The right to use all photographs, pictures, portraits, vocal sounds, appearances/likenesses, video and performances (hereinafter collectively known as “image”) of me in the possession of The Church of Saint Raphael ; The right to use, reproduce, publish, exhibit, distribute, and transmit the image of me individually or in conjunction with other images or printed matter in the production of brochures, slides, motion pictures, broadcasts (radio, television, and other social and digital media), audio or video files, recordings, still photography, CD-Rom and any other manner of media now known or later developed; The right to use, reproduce, publish, exhibit, distribute, and transmit the image of me individually or in conjunction with other images or printed matter onThe Church of Saint Raphael and the Archdiocese of Saint Paul and Minneapolis’s Internet websites. No home address or phone number will be published; The right to record, reproduce, amplify, edit, and simulate my image and all sound effects produced; The right to copyright, in the name of The Church of Saint Raphael and the Archdiocese of Saint Paul and Minneapolis, works that contain the image of me; The right to use and publish for general communications, advertising, commercial or publicity purposes, or for any other lawful purpose whatsoever my original work; and The right to assign the above-mentioned rights to third parties without notice to me. I understand that the video files, still photos, or other media incorporating the image of me will become the property of The Church of Saint Raphael / Archdiocese of St Paul & Minneapolis. I hereby waive the right to inspect or approve the image or any finished materials that incorporate the image. I understand and agree that no compensation will be provided, now or in the future, in connection with the use of my image or my original work. I hereby release, discharge, and agree to indemnify and hold harmlessThe Church of Saint Raphael the Archdiocese of Saint Paul and Minneapolis, and their agents, employees and assigns from any and all claims, demands, right, and causes of action of whatever kind that I have or may have or may arise by reason of this authorization and from the use of my image and original work, including but not limited to, all claims for libel and invasion of privacy. This consent regarding my likeness and original work is valid until such time as I choose to rescind this authorization and consent. If I choose to rescind this authorization and consent, I agree that I will inform The Church of Saint Raphael / Archdiocese of St Paul & Minneapolis in writing and that my rescission will not take effect until it is received by (insert name of parish/school/archdiocese). I understand and acknowledge that it may not be possible to recall any work or photos that have been published prior to receipt of my written rescission. I hereby authorize and consent that The Church of Saint Raphael and the Archdiocese of Saint Paul and Minneapolis have the right to use my name in connection with their educational, promotional, fund-raising activities, or for any other legitimate purpose. I have read the above Disclosures, Authorizations, and Releases, have had the opportunity to consider their terms, and understand them. I execute this document voluntarily and with full knowledge of its significance. I HAVE READ THE AUTHORIZATION ABOVE. I UNDERSTAND AND AGREE I HAVE HAD THE OPPORTUNITY TO CONSIDER THE TERMS AND UNDERSTAND THEM. BY SELECTING "YES, I AGREE," I UNDERSTAND AND AGREE THAT I AM VOLUNTARILY ACCEPTING THESE PROVISIONS WITH FULL KNOWLEDGE OF THE SIGNIFICANCE.
10
Family Caption for DirectoryExample: HAGEN, Bret and Mary; Nicholas (NP), Anthony (NP), Clare, Jonathan, Grant --- N.P. means “Not Pictured”
11
Can you provide your Mailing Address?
You may include my mailing address in the Saint Raphael ParishSoft Database
You may also include my mailing address in the back of the Saint Raphael Photo Directory
I do not want to provide my mailing address at this time, I recognize I will not be able to receive official mail communication
12
Can you provide your Mailing Address to be included in our database?Address
YESNO
13
Mailing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
14
Information Release
You may include my mailing address in the Saint Raphael Directory
15
Please select your Parishioner Status.
Please Select
Please Select
I am already a registered Parishioner - Verify my Information
I am not yet a registered Parishioner - I would like to be added - You will be contacted soon!
I would not like to officially register at this time
16
If applicable - Active Parishioner Envelope Number
17
Upload a photo below or click the link below to sign up for a photo session at Saint Raphael. You will be contacted with more details about Photo Session location.SIGN UP HERE
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
Should be Empty: