Parish Registration - Catholic Parishes of the Valley

Community*

(Head of Household)

Last Name*

Language*

Ethnicity

Sex*

Male
Female

Residence Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Mailing Addess*

Same as Residence Address

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Email*

Date of Birth*

Religion*

Sacraments Received

Baptism
Communion
Confirmation

Marriage Status*

Wedding Church Name, City, & State*

Anniversary Date*

Married by a Priest/Deacon*

Yes
No

Name of Celebrant*

Spouse's Name

Name*

Last Name*

Language*

Ethnicity

Address

Same as Residence Address

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email*

Phone

Date of Birth*

Religion*

Sacraments Received

Baptism
Communion
Confirmation

Children

How many kids do you have?

Child 1

Full Name*

Ethnicity

Language*

English
Spanish
Other

Date of Birth*

Sex*

Male
Female

Sacraments Received

Baptism
Communion
Confirmation

Child 2

Full Name*

Ethnicity

Language*

English
Spanish
Other

Date of Birth*

Sex*

Male
Female

Sacraments Received

Baptism
Communion
Confirmation

Child 3

Full Name*

Ethnicity

Language*

English
Spanish
Other

Date of Birth*

Sex*

Male
Female

Sacraments Received

Baptism
Communion
Confirmation

Child 4

Full Name*

Ethnicity

Language*

English
Spanish
Other

Date of Birth*

Sex*

Male
Female

Sacraments Received

Baptism
Communion
Confirmation

Child 5

Full Name*

Ethnicity

Language*

English
Spanish
Other

Date of Birth*

Sex*

Male
Female

Sacraments Received

Baptism
Communion
Confirmation

Child 6

Full Name*

Ethnicity

Language*

English
Spanish
Other

Date of Birth*

Sex*

Male
Female

Sacraments Received

Baptism
Communion
Confirmation

Additional Information

How would you like to support the parish?*

E-Giving by Credit Card Through VANCO
ETF Monthly Electronic Transfer
Offertory Envelopes
Weekly Basket Collection

Is there anyone who is homebound?*

Yes
No

What attracted you to this parish?

Do you permit photos of you or your family members to be used in the bulletin, website or other church related materials?*

Yes
No

Name

This field is for validation purposes and should be left unchanged.