Holy Spirit Parish Registration Form

Contact Information

Family Last Name

Required*

Father's Name

Required*

Mother's Name

Required*

Custodial Parent, if different from above

Home Address

Street 1*

Street 2

City*

State*

Zip*

Required*

Both Parents Catholic?
Required*

	Yes
	No

Home or Main Cell Phone

Required* --

Mom/Dad Work/Cell:

Child 1

Child's Name

First Name

Last Name

Birth Date

Gender

	Male
	Female

Grade

Sacraments Completed

	Baptism
	Eucharist
	Reconciliation
	Confirmation

Special Needs: Medical, Learning Disabilities, Physical Disabilities

Child 2

Child's Name

First Name

Last Name

Birth Date

Gender

	Male
	Female

Grade

Sacraments Completed

	Baptism
	Eucharist
	Reconciliation
	Confirmation

Special Needs: Medical, Learning Disabilities, Physical Disabilities

Child 3

Child's Name

First Name

Last Name

Birth Date

Gender

	Male
	Female

Grade

Sacraments Completed

	Baptism
	Eucharist
	Reconciliation
	Confirmation

Special Needs: Medical, Learning Disabilities, Physical Disabilities

Child 4

Child's Name

First Name

Last Name

Birth Date

Gender

	Male
	Female

Grade

Sacraments Completed

	Baptism
	Eucharist
	Reconciliation
	Confirmation

Special Needs: Medical, Learning Disabilities, Physical Disabilities

Additional Details

Special Needs/Medication

Please list child's name & needs. Send procedure plan to parish office if needed.

Was each child registered here in Faith Formation last year?
Required*

	Yes
	No

If No, who, where & grade?

Parent Signature
Required*

I acknowledge that as the parent/guardian, this information will be submitted to the parish for use in registration.*

Yes

Once you submit this form, the confirmation page will have information to help you calculate your tuition and make an online payment.