Parish Registration Form

Child #1

Name

First Middle Last Goes By

Gender*

M
F

Birth Date*

Religion*

Catholic, Convert, Protestant, etc.

Baptism*

Please include date (Month / Day / Year and Place)
If not applicable put N/A

First Communion*

Please include date (Month / Day / Year and Place)
If not applicable put N/A

Confirmation*

Please include date (Month / Day / Year and Place)
If not applicable put N/A

Child #2

Name

First Middle Last Goes By

Gender*

M
F

Birth Date*

Religion*

Catholic, Convert, Protestant, etc.

Baptism*

Please include date (Month / Day / Year and Place)
If not applicable put N/A

First Communion*

Please include date (Month / Day / Year and Place)
If not applicable put N/A

Confirmation*

Please include date (Month / Day / Year and Place)
If not applicable put N/A

Child #3

Name

First Middle Last Goes By

Gender*

M
F

Birth Date*

Religion*

Catholic, Convert, Protestant, etc.

Baptism*

Please include date (Month / Day / Year and Place)
If not applicable put N/A

First Communion*

Please include date (Month / Day / Year and Place)
If not applicable put N/A

Confirmation*

Please include date (Month / Day / Year and Place)
If not applicable put N/A

Child #4

Name

First Middle Last Goes By

Gender*

M
F

Birth Date*

Religion*

Catholic, Convert, Protestant, etc.

Baptism*

Please include date (Month / Day / Year and Place)
If not applicable put N/A

First Communion*

Please include date (Month / Day / Year and Place)
If not applicable put N/A

Confirmation*

Please include date (Month / Day / Year and Place)
If not applicable put N/A

Child #5

Name

First Middle Last Goes By

Gender*

M
F

Birth Date*

Welcome

Step 1 of 3

General Information

Family Information

Sacraments

Spouse Information

Child #1

Child #2

Child #3

Child #4

Child #5

Additional Information

Thank you for choosing Immaculate Heart of Mary Catholic Church!