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FESTIVAL
April22
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/yyy
*
Address
*
Line 1
Line 2
City
State
Zip Code
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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
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