ENGLISH REGISTRATION

Holy Name of Mary Parish
Family Registration Form

* Indicates required field

Name of Head of Household *

First

Last

Phone Number *

Cell Phone Number *

Email *

Date of Birth mm/dd/yyyy *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Would you like to receive bi-monthly offertory envelopes *

Yes No

Name of Spouse/Partner *

First

Last

Phone Number *

Cell Phone Number *

Email *

Date of Birth mm/dd/yyyy *

Child #1 *

First

Last

Date of Birth mm/dd/yyyy *

Gender *

Male Female

Child #2 *

First

Last

Date of Birth mm/dd/yyyy *

Gender *

Male Female

Child #3 *

First

Last

Date of Birth mm/dd/yyyy *

Gender *

Male Female

Child #4 *

First

Last

Date of Birth mm/dd/yyyy *

Gender *

Male Female

Child #5 *

First

Last

Date of Birth mm/dd/yyyy *

Gender *

Male Female

Submit Our Registration

Holy Name of Mary Parish ​Family Registration Form

Holy Name of Mary Parish
Family Registration Form