St. John Vianney Catholic Church Registration
Please complete the Registration Form and someone from our office will contact you about registering with the church
Last Name *
First Name *
Spouses Name
Street Address *
City *
State *
Zipcode *
Primary Phone # *
If this Is a Cell phone is it okay to text you? *
Secondary Phone #
Family Email Address *
CHILD #1 INFORMATION
Child's #1 Last Name
Child #1 First Name
Child #1 Gender
Child #1 Date of Birth
MM
/
DD
/
YYYY
Child #1 Grade
CHILD #2 INFORMATION
Child #2 Last Name
Child #2 First Name
Child #2 Gender
Clear selection
Child #2 Date of Birth
MM
/
DD
/
YYYY
Child #2 Grade
CHILD #3 INFORMATION
Child #3 Last Name
Child #3 First Name
Child #3 Gender
Clear selection
Child #3 Date of Birth
MM
/
DD
/
YYYY
Child #3 Grade
CHILD #4 INFORMATION
Child #4 Last Name
Child #4 First Name
Child #4 Gender
Clear selection
Child #4 Date of Birth
MM
/
DD
/
YYYY
Child #4
CHILD #5 INFORMATION
Child #5 Last Name
Child #5 First Name
Child #5 Gender
Clear selection
Child #5 Date of Birth
MM
/
DD
/
YYYY
Child #5 Grade
Sacramental Information
Family Sacramental Information *
Baptism
Baptism & Confession
Baptism, Confession, & Communion
N/A
1st Person
2nd Person
Child 1
Child 2
Child 3
Child 4
Child 5
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