Parish Registration

Street Address 1 REQUIRED Please fill out this field. Please enter valid data.

Street Address 2 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 Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Our Phone Number is unlisted

I would like to receive periodic parish text messages to this number REQUIRED Yes No Please fill out this field.

Family Email REQUIRED Please fill out this field. Please enter an email address.

Head of Household

Spouse

Other Members

First Name Please enter valid data.

Last Name Please enter valid data.
Date of Birth Please enter a date.
School and Grade (if applicable) Please enter valid data.
Baptism Yes No
Catholic First Communion Yes No
Catholic Confirmation Yes No
If you have more members, please list them here and note birthdate, gender, Baptism, First Communion and confirmation if applicable.
Do you or a family member have a disability that you would like us to know about? (optional)
Were there activities you enjoyed or ways you served at other parishes? Please list here.
Previous Parish Please enter valid data.

St. Elizabeth Ann Seton