Registration Form

This registration form allows for a family with 3 children or less to register. If you would like to register your family and you have more than 3 children, please call us at the office at 815-398-0853, drop in to fill out a paper form, or send a message to Kathleen after filling out this form with the appropriate information for additional children. Please do not fill out this form multiple times. Thank you!

Street Address
Street Address
Home Phone
Home Phone
Cell Phone
Cell Phone
Mailing Address (If Different)
Mailing Address (If Different)
Wedding Date (if applicable)
Wedding Date (if applicable)
Head of Household
Name *
Name
Birthdate *
Birthdate
Sex *
Baptism *
1st Eucharist *
Confirmation *
Spouse (if applicable)
Name
Name
Birthday
Birthday
Sex
Baptism
1st Eucharist
Confirmation
Children
Child 1 (Under 18 years of age)
Child 1 (Under 18 years of age)
Birthday
Birthday
Sex
Baptism
1st Eucharist
Confirmation
Child 2
Child 2
Birthday
Birthday
Sex
Baptism
1st Eucharist
Confirmation
Child 3
Child 3
Birthday
Birthday
Sex
Baptism
1st Eucharist
Confirmation