Our Lady of Victory Family Registration
Please fill this form out once for your family, then fill out the Member Registration for each person in your family, both adults and children. Thank you!
Are you updating an existing registration? *
Family Last Name *
Your answer
Date Registered *
MM
/
DD
/
YYYY
Family Status (ex. 1 or 2 parent family, divorced, empty nester, single, married) *
Your answer
Street Address *
Your answer
City, State, and Zip Code *
Your answer
Mailing Address *
Please fill out your phone numbers below.
Home Phone - Please indicate if it is unlisted. *
Your answer
Cell Phone *
Your answer
Family Email Address *
Your answer
If any member of your family is in a nursing home, please provide us with their name, the name of the nursing home, and their room number.
Your answer
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