St. Mary Atlanta Member Registration Form

Please complete this form to register or update the information of all the members of your household.

Main Church

St. Mary - Atlanta St. Mark- Atlanta St. Paul - Atlanta Other

Person Completing Form Information

Name

This address will receive a confirmation email

Phone

Address

Date of Birth

Head of Household

Yes No

Family Member Information

Please provide the details of the members living in your household.

Spouse Information

Spouse First Name

Spouse Last Name

Spouse Email

Spouse Phone

Spouse Date of Birth

Children Information

Child 1 First Name

Child 1 Last Name

Child 1 Date of Birth

Child 2 First Name

Child 2 Last Name

Child 2 Date of Birth

Child 3 First Name

Child 3 Last Name

Child 3 Date of Birth

Child 4 First Name

Child 4 Last Name

Child 4 Date of Birth

Child 5 First Name

Child 5 Last Name

Child 5 Date of Birth

Additional Members Living in Your Household

Please complete this section if there are persons living in this household that are not immediate family members.

Are there additional members living in this household?

Yes No

Additional Member 1

First Name

Last Name

Phone

Relation To You

Additional Member 2

First Name

Last Name

Phone

Relation To You

Comments

Please add any additional information you would like to.

** By submitting any phone number or email address on this form, you consent to receive SMS text messages and emails from the church. This consent also applies to all names and contact information provided. Please ensure you have obtained their approval before submitting the details.

St. Mary Atlanta Member Registration Form

Description

Please Fix the Following