Parishioner Registration

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- Head of Household
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name 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.
  
  Home Phone Please enter a phone number.
  
  Cell Phone REQUIRED Please fill out this field. Please enter a phone number.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Birthday REQUIRED Please fill out this field. Please enter a date.
  
  Occupation Please enter valid data.
  
  Do you need a ride to Mass? Yes No
  
  WVU Alumnus Yes No
  
  WVU Faculty or Staff? Please enter valid data.
- Spouse
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Street Address Please enter valid data.
  
  City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
  
  Home Phone Please enter a phone number.
  
  Cell Phone Please enter a phone number.
  
  Email Please enter an email address.
  
  Birthday Please enter a date.
  
  Occupation Please enter valid data.
  
  Do you need a ride to Mass? Yes No
  
  WVU Alumnus Yes No
  
  WVU Faculty or Staff? Please enter valid data.
- Children REQUIRED Please fill out this field.
  
  Child 1
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birthday REQUIRED Please fill out this field. Please enter a date.
  
  School REQUIRED Please fill out this field. Please enter valid data.
  
  Any additional information
  
  Child 2
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birthday REQUIRED Please fill out this field. Please enter a date.
  
  School REQUIRED Please fill out this field. Please enter valid data.
  
  Any additional information
  
  Child 3
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birthday REQUIRED Please fill out this field. Please enter a date.
  
  School REQUIRED Please fill out this field. Please enter valid data.
  
  Any additional information
  
  Child 4
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birthday REQUIRED Please fill out this field. Please enter a date.
  
  School REQUIRED Please fill out this field. Please enter valid data.
  
  Any additional information
  
  Child 5
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birthday REQUIRED Please fill out this field. Please enter a date.
  
  School REQUIRED Please fill out this field. Please enter valid data.
  
  Any additional information
  
  Child 6
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birthday REQUIRED Please fill out this field. Please enter a date.
  
  School REQUIRED Please fill out this field. Please enter valid data.
  
  Any additional information
  
  Child 7
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birthday REQUIRED Please fill out this field. Please enter a date.
  
  School REQUIRED Please fill out this field. Please enter valid data.
  
  Any additional information
  
  Child 8
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birthday REQUIRED Please fill out this field. Please enter a date.
  
  School REQUIRED Please fill out this field. Please enter valid data.
  
  Any additional information
  
  Child 9
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birthday REQUIRED Please fill out this field. Please enter a date.
  
  School REQUIRED Please fill out this field. Please enter valid data.
  
  Any additional information
  
  Child 10
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birthday REQUIRED Please fill out this field. Please enter a date.
  
  School REQUIRED Please fill out this field. Please enter valid data.
  
  Any additional information
Submit