Parish Registration

Use this form to register in Holy Child Parish. This information will be held in confidence for pastoral use only. If you have questions regarding this form, please contact the Parish Office at 856-939-1681.

Family Information

All information will be held in confidence for pastoral use only.

Family Name

Required*

Address

Street 1*

Street 2

City*

State*

Zip*

Primary phone number

Secondary phone number

Unlisted?

	Yes
	No

Star Herald

Yes, I would like to receive the Star Herald

No, I would not like to receive the Star Herald

Head of Household

Name

Title

First Name

Middle Name

Last Name

Date of Birth

Sex

	Male
	Female

Occupation

Religion

Ethnicity

Marital Status

Where were you married?

If you were not married in a Catholic Church, would you like your marriage blessed?

Sacraments Received

	Baptism
	First Penance
	Eucharist (First Holy Communion)
	Confirmation
	Matrimony

Please list dates each sacrament was received, if known

Spouse (if applicable)

Name

First Name

Last Name

Date of Birth

Sex

	Male
	Female

Occupation

Religion

Ethnicity

Marital Status

Sacraments Received

	Baptism
	First Penance
	Eucharist (First Holy Communion)
	Confirmation
	Matrimony

Please list dates each sacrament was received, if known

Children

Children living at home	For each child, please enter the Full Name, Date of Birth, Sex, School, Grade, and Sacraments received.

Other Adults In Household

Other Adults	For each additional adult living in the home, please enter the Full Name, Date of Birth, Sex, Religion, Relationship to you and Sacraments received.

Interests

Please contact me with information about the ministries and organizations I have indicated below:

Do you have any suggestions that would help us serve you better?

Are there other ways that you would like to be involved with our parish community?

Is anyone in your household homebound or have any special needs?

Submitted By

Name	Required*
Phone	Required* --
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