Epiphany Registration - The Church of the Epiphany

Parish Registration

Please fill out this online form and submit it to get started at Epiphany.

It would be great to have you included in the Parish Directory App. Please email a family photo to Jean EMAIL. Your family name, address and phone number will appear unless you tell us otherwise.

Date Joined

Family Last Name *

Phone *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

1st Adult

Name - 1st Adult *

Birthdate - 1st Adult *

Religion - 1st Adult *

Email - 1st Adult *

Cell - 1st Adult

Employer - 1st Adult

Position - 1st Adult

2nd Adult

Name - 2nd Adult

Birthdate - 2nd Adult

Religion - 2nd Adult

Email - 2nd Adult

Cell - 2nd Adult

Employer - 2nd Adult

Position - 2nd Adult

Marriage Date

Place

Name of Children in household

Please include last name if different from above

1st Child

First

Last

Birthdate - 1st Child

Baptized? - 1st Child

2nd Child

First

Last

Birthdate - 2nd Child

Baptized? - 2nd Child

3rd Child

First

Last

Birthdate - 3rd Child

Baptized? - 3rd Child

4th Child

First

Last

Birthdate - 4th Child

Baptized? - 4th Child

5th Child

First

Last

Birthdate - 5th Child

Baptized? - 5th Child

Comments

Phone

Parish Registration

1st Adult

2nd Adult

Name of Children in household

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