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Family Registration

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Become a Parishioner!

Make your parish and faith involvement easier by registering today! We highly encourage you to provide and upload all information and documents possible corresponding to your completed sacraments so that we can keep an updated and consistent record. This will also make future registration for things like CCD easier and quicker because we won't require you to upload documents again!
The maximum number of form submissions has been reached. This form is currently not available.
- General Family Information
  In this section, we ask for information that is general to the family. We will only ask for the home address once. An email and phone number are required in this section only, but please feel free to fill out the emails and phone numbers of as many family members as you'd like. This way, everyone can stay informed together about parish-related notifications and activities.
- Address REQUIRED Please fill out this field. 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.
- Primary Email REQUIRED
  A copy of this completed form will be sent to this email.
  Please fill out this field. Please enter an email address.
- Primary Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Family Members REQUIRED
  Please select the total number of people you will be registering today as part of this family.
  Please fill out this field.
  
  Member 1
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  Email Please enter an email address.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Role REQUIRED Parent/Guardian Other member Please fill out this field.
  
  Date of Birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter valid data.
  
  Sacraments Already Received REQUIRED Baptism Communion Confirmation Marriage None Please fill out this field.
  
  Member 2
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  Email Please enter an email address.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Role REQUIRED Parent/Guardian Other member Please fill out this field.
  
  Date of Birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter valid data.
  
  Sacraments Already Received REQUIRED Baptism Communion Confirmation Marriage None Please fill out this field.
  
  Member 3
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  Email Please enter an email address.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Role REQUIRED Parent/Guardian Other member Please fill out this field.
  
  Date of Birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter valid data.
  
  Sacraments Already Received REQUIRED Baptism Communion Confirmation Marriage None Please fill out this field.
  
  Member 4
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  Email Please enter an email address.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Role REQUIRED Parent/Guardian Other member Please fill out this field.
  
  Date of Birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter valid data.
  
  Sacraments Already Received REQUIRED Baptism Communion Confirmation Marriage None Please fill out this field.
  
  Member 5
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  Email Please enter an email address.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Role REQUIRED Parent/Guardian Other member Please fill out this field.
  
  Date of Birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter valid data.
  
  Sacraments Already Received REQUIRED Baptism Communion Confirmation Marriage None Please fill out this field.
  
  Member 6
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  Email Please enter an email address.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Role REQUIRED Parent/Guardian Other member Please fill out this field.
  
  Date of Birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter valid data.
  
  Sacraments Already Received REQUIRED Baptism Communion Confirmation Marriage None Please fill out this field.
  
  Member 7
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  Email Please enter an email address.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Role REQUIRED Parent/Guardian Other member Please fill out this field.
  
  Date of Birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter valid data.
  
  Sacraments Already Received REQUIRED Baptism Communion Confirmation Marriage None Please fill out this field.
  
  Member 8
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  Email Please enter an email address.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Role REQUIRED Parent/Guardian Other member Please fill out this field.
  
  Date of Birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter valid data.
  
  Sacraments Already Received REQUIRED Baptism Communion Confirmation Marriage None Please fill out this field.
  
  Member 9
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  Email Please enter an email address.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Role REQUIRED Parent/Guardian Other member Please fill out this field.
  
  Date of Birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter valid data.
  
  Sacraments Already Received REQUIRED Baptism Communion Confirmation Marriage None Please fill out this field.
  
  Member 10
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  Email Please enter an email address.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Role REQUIRED Parent/Guardian Other member Please fill out this field.
  
  Date of Birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter valid data.
  
  Sacraments Already Received REQUIRED Baptism Communion Confirmation Marriage None Please fill out this field.
  
  Member 11
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  Email Please enter an email address.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Role REQUIRED Parent/Guardian Other member Please fill out this field.
  
  Date of Birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter valid data.
  
  Sacraments Already Received REQUIRED Baptism Communion Confirmation Marriage None Please fill out this field.
  
  Member 12
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  Email Please enter an email address.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Role REQUIRED Parent/Guardian Other member Please fill out this field.
  
  Date of Birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter valid data.
  
  Sacraments Already Received REQUIRED Baptism Communion Confirmation Marriage None Please fill out this field.
  
  Member 13
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  Email Please enter an email address.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Role REQUIRED Parent/Guardian Other member Please fill out this field.
  
  Date of Birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter valid data.
  
  Sacraments Already Received REQUIRED Baptism Communion Confirmation Marriage None Please fill out this field.
  
  Member 14
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  Email Please enter an email address.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Role REQUIRED Parent/Guardian Other member Please fill out this field.
  
  Date of Birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter valid data.
  
  Sacraments Already Received REQUIRED Baptism Communion Confirmation Marriage None Please fill out this field.
  
  Member 15
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  Email Please enter an email address.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Role REQUIRED Parent/Guardian Other member Please fill out this field.
  
  Date of Birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter valid data.
  
  Sacraments Already Received REQUIRED Baptism Communion Confirmation Marriage None Please fill out this field.
- Sacrament Certificate Upload
  
  Proceed to upload the documents corresponding to each completed sacrament by clicking the button below. To upload documents for multiple people, first complete the form once for the first person and click on "Submit another response". Do this for as many family members as you would like. Return to this form once complete.
  
  Suba los documentos de cada sacramento con en botón de abajo. Cuando termine, regrese a esta forma. Para subir documentos para varias personas, primero complete la forma una vez para la primera persona y presiona el botón que dice "Submit another response". Haga esto para todos los miembros de la familia.
  
  Upload Documents
- If you would like to be added to an existing family, please list the names of the main contact(s) of that family below to appropriately assign you.
- Existing Family Contact
  Below, list a couple of details of the existing family or their main contact to correctly assign you to them.
- Additional Information
Total:

Submit

Proceed to Payment

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SAINT AGNES

CATHOLIC CHURCH

Family Registration

Become a Parishioner!