Register at our Parish

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  Thanks for taking a moment to register your household's information with our parish's office.
  
  Please fill out the form as completely as possible and then click submit.
  
  Name of Husband Please enter valid data.
  
  Name of Wife Please enter valid data.
  
  First and Last Name(s) of Other Adult(s) in Household
  
  First and Last Names of Child(ren) in Household
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Home Address Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Other Preferred Means of Communication? Please list here.
  
  Is this information? Brand new information An Update to a Current Household Listing?
  
  Submit
  
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