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In registering to be a member of Immaculate Conception Church, you express a commitment to worship regularly with our parish community, participate in the ministry of the parish to bring Christ to other people, support the parish financially, and take an active part in parish activities. We welcome you!
Register at our parish
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- General Information
  
  Please check one: REQUIRED Please update my parishioner record. Please register me as a new parishioner. Please fill out this field.
  
  Please check one: REQUIRED I am registering as an individual. I am registering as a family. Please fill out this field.
- Member Information
  
  Family Name REQUIRED Please fill out this field. Please enter valid data.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Date of birth (month/day/year) REQUIRED Please fill out this field. Please enter valid data.
  
  Street Address REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Home Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Cell Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Other Members
  
  Would you like to register a spouse or child with whom you share your household? Yes No
  
  Spouse's Name Please enter valid data.
  
  Child 1 (full name and date of birth) Please enter valid data.
  
  Child 2 (full name and date of birth) Please enter valid data.
  
  Child 3 (full name and date of birth) Please enter valid data.
  
  Child 4 (full name and date of birth) Please enter valid data.
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Immaculate conception church

City, ST

New Parish Members Register

Register at our parish