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Parish Registration

Please fill out the form below. You may also click the button to download the PDF version, fill it out, and return it to the Parish Office.

Parish Registration PDF

Parish Registration

Compelled by the Gospel, we the parish of Sacred Heart, promote and support Christian life by serving our parish and community through the celebration of the sacraments, educational programs, and other parish ministries.

Family Last Name

Email

Primary Phone

Cell Phone

Emergency Contact Name

Emergency Contact Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Interested in Online Giving

Yes

No

Interested in Receiving Envelopes

Yes

No

Please note any special needs, disabilities, or languages:

Family Members

Please provide the names and information to ALL members of the household below:

Name

First Last

Birth Date

MM slash DD slash YYYY

Relationship

Occupation

Gender

Male

Female

Catholic

Yes

No

Baptized

Yes

No

First Communion

Yes

No

Confirmed

Yes

No

Add another family member?

Yes

No

Family Members

Please provide the names and information to ALL members of the household below:

Name

First Last

Birth Date

MM slash DD slash YYYY

Relationship

Occupation

Gender

Male

Female

Catholic

Yes

No

Baptized

Yes

No

First Communion

Yes

No

Confirmed

Yes

No

Add another family member?

Yes

No

Family Members

Please provide the names and information to ALL members of the household below:

Name

First Last

Birth Date

MM slash DD slash YYYY

Relationship

Occupation

Gender

Male

Female

Catholic

Yes

No

Baptized

Yes

No

First Communion

Yes

No

Confirmed

Yes

No

Add another family member?

Yes

No

Family Members

Please provide the names and information to ALL members of the household below:

Name

First Last

Birth Date

MM slash DD slash YYYY

Relationship

Occupation

Gender

Male

Female

Catholic

Yes

No

Baptized

Yes

No

First Communion

Yes

No

Confirmed

Yes

No

Add another family member?

Yes

No

Family Members

Please provide the names and information to ALL members of the household below:

Name

First Last

Birth Date

MM slash DD slash YYYY

Relationship

Occupation

Gender

Male

Female

Catholic

Yes

No

Baptized

Yes

No

First Communion

Yes

No

Confirmed

Yes

No

Add another family member?

Yes

No

Family Members

Please provide the names and information to ALL members of the household below:

Name

First Last

Birth Date

MM slash DD slash YYYY

Relationship

Occupation

Gender

Male

Female

Catholic

Yes

No

Baptized

Yes

No

First Communion

Yes

No

Confirmed

Yes

No

Add another family member?

Yes

No

Family Members

Please provide the names and information to ALL members of the household below:

Name

First Last

Birth Date

MM slash DD slash YYYY

Relationship

Occupation

Gender

Male

Female

Catholic

Yes

No

Baptized

Yes

No

First Communion

Yes

No

Confirmed

Yes

No

Add another family member?

Yes

No

Family Members

Please provide the names and information to ALL members of the household below:

Name

First Last

Birth Date

MM slash DD slash YYYY

Relationship

Occupation

Gender

Male

Female

Catholic

Yes

No

Baptized

Yes

No

First Communion

Yes

No

Confirmed

Yes

No

Sacred Heart Catholic Church

7190 Highway 17 South Fleming Island, FL 32003

P: (904) 284-3811

frontdesk@sacredheartcatholicchurch.org

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Parish Registration

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