stiggys-noreply@gmail.com_20250724_090540Download "*" indicates required fields NameThis field is for validation purposes and should be left unchanged.FAMILY INFORMATIONFamily Name*Home Parish*Prefered Mass Time* Saturday, 5:00 pm (St. Ignatius) Sunday, 8:00 am(St. Ignatius) Sunday, 9:30 am (Our Lady of Mount Carmel) Sunday, 11:30 am (St. Ignatius) Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Father's Name*Catholic* Yes No Mother's Name*Catholic* Yes No Contact InformationPrimary Contact* Father Mother Other Secondary Contact Information* Father Mother Other Primary Phone Number*Secondary Phone Number*Primary Email Adress Secondary Email Address Child 1Name First Middle Last Untitled* Male Female Birthdate* MM slash DD slash YYYY Grade as of 9/1/25*School*List of allergies, current medications or other pertinent information: Check for non-traditional Sacramental Preparation (did not recieve Reconciliation/Eucharist in 2nd grade) Another child? 2 I need to enter another child’s information. Child 2Name First Middle Last Untitled Male Female Birthdate MM slash DD slash YYYY Grade as of 9/1/25SchoolList of allergies, current medications or other pertinent information: Check for non-traditional Sacramental Preparation (did not recieve Reconciliation/Eucharist in 2nd grade) Another child? 3 I need to enter another child’s information. Child 3Name First Middle Last Untitled Male Female Birthdate MM slash DD slash YYYY Grade as of 9/1/25SchoolList of allergies, current medications or other pertinent information: Check for non-traditional Sacramental Preparation (did not recieve Reconciliation/Eucharist in 2nd grade) Another child? 4 I need to enter another child’s information. Child 4Name First Middle Last Untitled Male Female Birthdate MM slash DD slash YYYY Grade as of 9/1/25SchoolList of allergies, current medications or other pertinent information: Check for non-traditional Sacramental Preparation (did not recieve Reconciliation/Eucharist in 2nd grade) Another child? 5 I need to enter another child’s information. Child 5Name First Middle Last Untitled Male Female Birthdate MM slash DD slash YYYY Grade as of 9/1/25List of allergies, current medications or other pertinent information: Check for non-traditional Sacramental Preparation (did not recieve Reconciliation/Eucharist in 2nd grade) PHOTO RELEASEI understand that through their participation in this program, my child(ren) listed on this registration may be photographed for use in promotion of programs.* You have my permission for my child(ren) to be photographed You DO NOT have my permission for my child(ren) to be photographed CAPTCHA
