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* 1. May we publish your contact information in our parish directory?

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* 2. Last Name of Family / Registrant

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* 3. Mailing Address

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* 4. Communication Information

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* 5. Male Adult in Household

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* 6. Female Adult in Household

If you have children in your household, please provide information about each child.

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* 7. Child #1

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* 8. Child #2

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* 9. Child #3

NOTE: If you have additional children, they may be added later on this form.

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* 10. Please contact me about using my talents in the following parish ministries (check all that apply). Contact the Parish Office at 440-256-1412 for additional information about our various ministries.

Thank you for registering with our parish and WELCOME! (If you have additional children, please provide information about each additional  child below.)

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* 11. Child #4

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* 12. Child #5

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* 13. Child #6

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