Santa Clara Church

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Parish Registration Form

Family Name*
Email*
Phone*
Address*
Street Address Address Line 2 City State ZIP Code
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Individual Information
Number of Adults you are registering*
Please enter a number from 1 to 4.
Number of Children you are registering*
Please enter a number from 0 to 10.
Adult 1
1. Adult Name*
First Last
1. Religion*
1. Sacraments Received*
- Baptism
- First Eucharist
- Confirmation
1. Date of Birth*
Date Format: MM slash DD slash YYYY
1. Occupation
1. Cell Phone
Adult 2
2. Adult Name
First Last
2. Religion
2. Sacraments Received
- Baptism
- First Eucharist
- Confirmation
2. Date of Birth
Date Format: MM slash DD slash YYYY
2. Occupation
2. Cell Phone
Child 1
1. Child's Name
First Last
Sex:*
- Male
- Female
1. Child 1 Religion
1. Child's Date of Birth
Date Format: MM slash DD slash YYYY
1. Sacraments already received by child
- Baptism
- First Eucharist
- Confirmation
1. Child's School
1. Child's Grade
Child 2
2. Child's Name
First Last
Sex:*
- Male
- Female
2. Child's Religion
2. Child's Date of Birth
Date Format: MM slash DD slash YYYY
2. Sacraments already received by child
- Baptism
- First Eucharist
- Confirmation
2. Child's School
2. Child's Grade
Child 3
3. Child's Name
First Last
Sex:*
- Male
- Female
3. Child's Religion
3. Child's Date of Birth
Date Format: MM slash DD slash YYYY
3. Sacraments already received by child
- Baptism
- First Eucharist
- Confirmation
3. Child's School
3. Child's Grade
Child 4
4. Child's Name
First Last
Sex:*
- Male
- Female
4. Child's Religion
4. Child's Date of Birth
Date Format: MM slash DD slash YYYY
4. Sacraments already received by child
- Baptism
- First Eucharist
- Confirmation
4. Child's School
4. Child's Grade
Additional Children
Please List additional children and their information below
Name / Religion / DOB / Sacraments Received / School / Grade

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Santa Clara Church

Parish Registration Form

Individual Information

Adult 1

Adult 2

Child 1

Child 2

Child 3

Child 4

Additional Children