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Parish Registration

- About Us

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- Welcome! We are so glad that you are interested in registering as a parishioner of either Saint Hilary of Poitiers or Saint Anthony of Padua! Please fill out the form below as thoroughly as possible and we will be in contact with you as soon as possible to help you feel welcomed into our parish. After you complete the form, we invite you to take a look at some of our ministries to see if the Lord is calling you to serve in a particular way!
- New Parishioner Registration For: REQUIRED Saint Hilary of Poitiers | Raceland, LA Saint Anthony of Padua | Gheens, LA Please fill out this field.
- Head of Household Information
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Middle Name REQUIRED Please fill out this field. Please enter valid data.
- Suffix REQUIRED Please fill out this field.
- Birth Date REQUIRED Please fill out this field. Please enter a date.
- Birthplace (City, State) REQUIRED Please fill out this field. Please enter valid data.
- Religion REQUIRED Please fill out this field. Please enter valid data.
- Preferred Language REQUIRED Please fill out this field. Please enter valid data.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- 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.
- Mailing Address (if different from address above) Please enter valid data.
- City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
- Ethnicity REQUIRED Please fill out this field.
- Marital Status REQUIRED Please fill out this field.
- Mass Attendance REQUIRED Please fill out this field.
- Sacraments Received REQUIRED Baptism First Communion Confirmation Matrimony None Please fill out this field.
- Spouse's Information
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- Middle Name Please enter valid data.
- Maiden Name Please enter valid data.
- Birth Date Please enter a date.
- Birthplace (City, State) Please enter valid data.
- Religion Please enter valid data.
- Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Ethnicity
- Mass Attendance
- Sacraments Received Baptism First Communion Confirmation None
- Additional Family Members
- Additional Members of the Household REQUIRED
  Please enumerate how many other individuals live in your household (children, parents, etc.)
  Please fill out this field.
  
  Household Member 1
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Suffix
  
  Birth Date Please enter a date.
  
  Ethnicity
  
  Gender
  
  Sacraments Received Baptism First Communion Confirmation None
  
  Name of School & Grade (if applicable) Please enter valid data.
  
  Relationship to Household Please enter valid data.
  
  Household Member 2
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Suffix
  
  Birth Date Please enter a date.
  
  Ethnicity
  
  Gender
  
  Sacraments Received Baptism First Communion Confirmation None
  
  Name of School & Grade (if applicable) Please enter valid data.
  
  Relationship to Household Please enter valid data.
  
  Household Member 3
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Suffix
  
  Birth Date Please enter a date.
  
  Ethnicity
  
  Gender
  
  Sacraments Received Baptism First Communion Confirmation None
  
  Name of School & Grade (if applicable) Please enter valid data.
  
  Relationship to Household Please enter valid data.
  
  Household Member 4
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Suffix
  
  Birth Date Please enter a date.
  
  Ethnicity
  
  Gender
  
  Sacraments Received Baptism First Communion Confirmation None
  
  Name of School & Grade (if applicable) Please enter valid data.
  
  Relationship to Household Please enter valid data.
  
  Household Member 5
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Suffix
  
  Birth Date Please enter a date.
  
  Ethnicity
  
  Gender
  
  Sacraments Received Baptism First Communion Confirmation None
  
  Name of School & Grade (if applicable) Please enter valid data.
  
  Relationship to Household Please enter valid data.
  
  Household Member 6
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Suffix
  
  Birth Date Please enter a date.
  
  Ethnicity
  
  Gender
  
  Sacraments Received Baptism First Communion Confirmation None
  
  Name of School & Grade (if applicable) Please enter valid data.
  
  Relationship to Household Please enter valid data.
  
  Household Member 7
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Suffix
  
  Birth Date Please enter a date.
  
  Ethnicity
  
  Gender
  
  Sacraments Received Baptism First Communion Confirmation None
  
  Name of School & Grade (if applicable) Please enter valid data.
  
  Relationship to Household Please enter valid data.
  
  Household Member 8
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Suffix
  
  Birth Date Please enter a date.
  
  Ethnicity
  
  Gender
  
  Sacraments Received Baptism First Communion Confirmation None
  
  Name of School & Grade (if applicable) Please enter valid data.
  
  Relationship to Household Please enter valid data.
  
  Household Member 9
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Suffix
  
  Birth Date Please enter a date.
  
  Ethnicity
  
  Gender
  
  Sacraments Received Baptism First Communion Confirmation None
  
  Name of School & Grade (if applicable) Please enter valid data.
  
  Relationship to Household Please enter valid data.
  
  Household Member 10
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Suffix
  
  Birth Date Please enter a date.
  
  Ethnicity
  
  Gender
  
  Sacraments Received Baptism First Communion Confirmation None
  
  Name of School & Grade (if applicable) Please enter valid data.
  
  Relationship to Household Please enter valid data.
- Additional Information
- Is there a homebound resident of your household who would like to receive Holy Communion?
- Are you presently using Parish Support Envelopes?
- What would you like to see Saint Hilary/Saint Anthony offer to help you pray and serve?
- Additional Needs or Notes
Submit

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Parish Registration

Head of Household Information

Spouse's Information

Additional Family Members

Additional Information