Registration Family Registration Form Last Name First Name Address Apt., Suite No. City State Zip Code Family Email Home Phone Emergency Phone Current/Previous Parish (Columbus Diocese) Individual Member Information Male Adult Female Adult Last Name First Name Last Name First Name Maiden Name Date of Birth Date of Birth Email Email Work / Cell Phone Work / Cell Phone Languages Languages Baptism Date Baptism Date Baptism Location Baptism Location First Communion Date First Communion Date First Communion Location First Communion Location Confirmation Date Confirmation Date Confirmation Location Confirmation Location Marital Status Single Married Separated Divorced Widowed Wedding Date Wedding Location Celebrant Name Additional Family / Children Do you have children under age 18 living in your household? Yes No Child 1 Has this child been baptized? Yes, baptized catholic Yes, baptized in another faith No, not baptized Has this child received First Communion? Yes No Has this child received Confirmation? Yes No Child 2 Has this child been baptized? Yes, baptized catholic Yes, baptized in another faith No, not baptized Has this child received First Communion? Yes No Has this child received Confirmation? Yes No Child 3 Has this child been baptized? Yes, baptized catholic Yes, baptized in another faith No, not baptized Has this child received First Communion? Yes No Has this child received Confirmation? Yes No Child 4 Has this child been baptized? Yes, baptized catholic Yes, baptized in another faith No, not baptized Has this child received First Communion? Yes No Has this child received Confirmation? Yes No Child 5 Has this child been baptized? Yes, baptized catholic Yes, baptized in another faith No, not baptized Has this child received First Communion? Yes No Has this child received Confirmation? Yes No Send
