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Cluster Parish Registration

Welcome! If you would like to join our Parish, or you've recently changed mailing or phone information, please fill out the form below. This information will be used by the St Rose of Lima, St Anthony of Padua and Immaculate Conception Cluster Parishes to contact you regarding our Parishes. Your information will only be used for our records and will not be sold. Thank you for for taking this moment to register your household's information with our parish's office. Please fill out the form as completely as possible and then click submit.

Which Parish are you registering or updating membership?
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Is this information:
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Household Information
Family last name
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Physical Address
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Mailing Address if different from above
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Primary Phone --
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Other information
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Are there any special needs or specific questions for us?
Head of Household Adult information
First and Last Name
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Date of Birth //
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Status
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Date and Place of Marriage
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Sacraments
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Check all completed Sacraments
Month, Year and Place of Baptism
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Secondary Phone --
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Email Address
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Ministries and Skills
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Please share Ministries, Skills, Occupation trade you can share at church
Adult two information
First and Last Name
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Date of Birth //
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Status
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Date and Place of Marriage
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Sacraments
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Month, Year and Place of Baptism
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Secondary Phone --
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E-mail address
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Ministries and Skills
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Please share Ministries, Skills, Occupation trade you can share at church
Dependent Children at home
Children are considered members with their parents until they are adults; no longer a dependent or living at home. Once they are on their own, it is their responsibility to attend church and to register as a member independent of their parents
First Child Name
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First Child Birth Date //
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First Child Gender
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First Child Sacraments Completed
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First Child Date and Place of each Sacrament completed
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Second Child Name
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Second Child Birth Date //
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Second Child Gender
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Second Child Sacraments completed
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Second Child Date and Place of each Sacrament completed
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Third Child Name
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Third Child Birth Date //
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Third Child Gender
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Third Child Sacraments Completed
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Third Child Dates and Places of each Sacrament completed
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Fourth Child Name
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Fourth Child Birth Date //
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Fourth Child Gender
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Fourth Child Sacraments completed
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Fourth Child Date and Place of each Sacrament completed
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additional children
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List all information as requested for each child above for all additional children
Childrens areas of participation
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For each child - please share the areas of participation and sharing talents and treasure, such as Youth Giving Envelopes, Advent program, Altar Server, Mission Supper, Event helpers, Community Volunteering .....
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