Registration

St. Luke the Evangelist Catholic Church
Online Registration

Today's Date *
Today's Date
Contact Information
Name *
Name
Address *
Address
Parish Status
Select one
Gender
Date of Birth
Date of Birth
Home Phone *
Home Phone
Phone Number
Work Phone
Work Phone
Phone Number
Cell Phone
Cell Phone
Phone Number
May we share your information with parish groups?
Check all that apply
Catholic?
Valid Catholic Marriage
Select one
Do we have permission to photograph or record (video/audio) this member for the use of media or website?
Individual Member #2 (please skip if you are a single parent)
Member #2 Name
Member #2 Name
Parish Status
Select one
Date of Birth
Date of Birth
Work Phone
Work Phone
Phone Number
Cell Phone
Cell Phone
Phone Number
Catholic?
Do we have permission to photograph or record (video/audio) this member for the use of media or website?
Individual Member #3
Member #3 Name
Member #3 Name
Date of Birth
Date of Birth
Catholic?
Do we have permission to photograph or record (video/audio) this member for the use of media or website?
Individual Member #4
Member #4 Name
Member #4 Name
Date of Birth
Date of Birth
Catholic?
Do we have permission to photograph or record (video/audio) this member for the use of media or website?
Please provide similar information about any additional family member(s) who wish to join St. Luke's
Do we have permission to photograph or record (video/audio) these members for the use of media or website?

Remember to click SUBMIT when you have completed and reviewed all information to the best of your knowledge.