Parishioner's Registration
Providing us with birth dates helps us in determining the age-related needs of our parishioners. All information is confidential and for parish use only.
Registration Type *
Adult(s) (Principal)
Title *
Principal Name *
(first, last)
Your answer
Birthday *
mm/dd/yyyy
Your answer
Title for second adult
Name of second adult
(first, last)
Your answer
Birthday
(mm/dd/yyyy)
Your answer
Wedding Anniversary
if applicable - mm/dd/yyyy
Your answer
Address *
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
Home Phone *
Your answer
Cell Phone
Your answer
Work Phone
Your answer
Email
Please provide us with your email address. Email is a very common method of communication today.
Your answer
Second email address if available
Your answer
Child (children)
male or female
Birthday- in order to register as a child in our religious education database, the full birthdate is required. All information is confidential.
mm/dd/yyyy
Your answer
child's name
first, last
Your answer
male or female
Birthday- in order to register as a child in our religious education database, the full birthdate is required. All information is confidential.
mm/dd/yyyy
Your answer
child's name
first, last
Your answer
child's name
first, last
Birthday- in order to register as a child in our religious education database, the full birthdate is required. All information is confidential.
mm/dd/yyyy
Your answer
child's name
first, last
Your answer
male or female
Birthday- in order to register as a child in our religious education database, the full birthdate is required. All information is confidential.
mm/dd/yyyy
Your answer
Additional Children at Home
Please list one child per line and list Name (first, last) and Birthdate (Birthdates must be complete for us to place children in our Religious Education database). all information is confidential.
Your answer
saintdom e-briefs
Saint Dominic Parish tries to reach out to parishioners using the current communication tools of today. Email is such a part of daily life now and an effective way of sending brief yet important information to our parishioners. We send out e-briefs approximately twice a month. These are usually highlights of current parish news and important information. In some instances we will use email for urgent information, such as cancelations due to weather. Urgent information will also appear on the home page of our website.

Please note: The Church of Saint Dominic and its web server protect the privacy of your email address, which will never be made accessible to any other party.

Children away at college
Please list one child per line and list Name (first, last), Birthdate, Email, School and Address
Your answer
Others Living In Household
Please list one person per line and list Name (first, last), Birthdate and Email
Your answer
Other Comments, Interests & Needs
Your answer
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