Parish Registration | Boyne Valley Catholic Community

Church of Registration*

St. Augustine, Boyne Falls
St. Matthew, Boyne City
St. John, Praga

Residency*

Year Round
Summer
Winter

Will you use envelopes?*

Yes
No

Head of Household

Name:*

First Middle Last

Maiden (if applicable):

Address*

Street Address Apt# City State ZIP Code

Alternative Address:

Home Phone #:*

Unlisted?

Yes

Other Phone #:

Email (required):*

Occupation:

Birthdate:

Employer:

Religion:

Baptism:

Yes
No

Date:

Church/City:

Sacramental Information (if known)

Confirmation:

Yes
No

Date:

Church/City:

First Eucharist:

Yes
No

Date:

Church/City:

Penance:

Yes
No

Date:

Church/City:

Spouse

Name:

First Middle Last

Maiden (if applicable):

Email (required):

Occupation:

Birthdate:

Employer:

Religion:

Baptism:

Yes
No

Date:

Church/City:

Sacramental Information (if known)

Confirmation:

Yes
No

Date:

Church/City:

First Eucharist:

Yes
No

Date:

Church/City:

Penance:

Yes
No

Date:

Church/City:

Marital Status:

Marriage Date:

Church Name:

City/State:

Children living in your home (under the age of 18 years)
[Anyone over 18 is considered an adult in the Catholic Church and should register separately.]

Add a child?

Yes

Child 1

Name:*

First Middle Last

Birthdate:

Gender

Male
Female

School

Grade

Baptism:

Yes
No

Date:

Church/City:

Confirmation:

Yes
No

Date:

Church/City:

First Eucharist:

Yes
No

Date:

Church/City:

Penance:

Yes
No

Date:

Church/City:

Add a child?

Yes

Child 2

Name:*

First Middle Last

Birthdate:

Gender

Male
Female

School

Grade

Baptism:

Yes
No

Date:

Church/City:

Confirmation:

Yes
No

Date:

Church/City:

First Eucharist:

Yes
No

Date:

Church/City:

Penance:

Yes
No

Date:

Church/City:

Add a child?

Yes

Child 3

Name:*

First Middle Last

Birthdate:

Gender

Male
Female

School

Grade

Baptism:

Yes
No

Date:

Church/City:

Confirmation:

Yes
No

Date:

Church/City:

First Eucharist:

Yes
No

Date:

Church/City:

Penance:

Yes
No

Date:

Church/City:

Add a child?

Yes

Child 4

Name:*

First Middle Last

Birthdate:

Gender

Male
Female

School

Grade

Baptism:

Yes
No

Date:

Church/City:

Confirmation:

Yes
No

Date:

Church/City:

First Eucharist:

Yes
No

Date:

Church/City:

Penance:

Yes
No

Date:

Church/City:

Add a child?

Yes

Child 5

Name:*

First Middle Last

Birthdate:

Gender

Male
Female

School

Grade

Baptism:

Yes
No

Date:

Church/City:

Confirmation:

Yes
No

Date:

Church/City:

First Eucharist:

Yes
No

Date:

Church/City:

Penance:

Yes
No

Date:

Church/City:

Add a child?

Yes

Child 6

Name:*

First Middle Last

Birthdate:

Gender

Male
Female

School

Grade

Baptism:

Yes
No

Date:

Church/City:

Confirmation:

Yes
No

Date:

Church/City:

First Eucharist:

Yes
No

Date:

Church/City:

Penance:

Yes
No

Date:

Church/City:

Add a child?

Yes

Child 7

Name:*

First Middle Last

Birthdate:

Gender

Male
Female

School

Grade

Baptism:

Yes
No

Date:

Church/City:

Confirmation:

Yes
No

Date:

Church/City:

First Eucharist:

Yes
No

Date:

Church/City:

Penance:

Yes
No

Date:

Church/City:

Add a child?

Yes

Child 8

Name:*

First Middle Last

Birthdate:

Gender

Male
Female

School

Grade

Baptism:

Yes
No

Date:

Church/City:

Confirmation:

Yes
No

Date:

Church/City:

First Eucharist:

Yes
No

Date:

Church/City:

Penance:

Yes
No

Date:

Church/City:

Add a child?

Yes

Child 9

Name:*

First Middle Last

Birthdate:

Gender

Male
Female

School

Grade

Baptism:

Yes
No

Date:

Church/City:

Confirmation:

Yes
No

Date:

Church/City:

First Eucharist:

Yes
No

Date:

Church/City:

Penance:

Yes
No

Date:

Church/City:

Additional Information

Should we be aware of any handicaps?

Would you be interested in joining or learning more information about:

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