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Parish Registration Form

Welcome to our parish family! Simply complete the online registration form below. You will receive a confirmation of your parish registration, and a member of our hospitality team will contact you to ensure that all of your questions are answered.
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- First Name REQUIRED Please fill out this field. Please enter valid data.
- Nickname Please enter valid data.
- Middle Name REQUIRED Please fill out this field. Please enter valid data.
- Last Name/Surname REQUIRED Please fill out this field. Please enter valid data.
- Maiden Name (if applicable) Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- 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.
- Email Please enter an email address.
- Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- How would you like to be contacted by the Welcoming Committee? REQUIRED Text Call Email Please fill out this field.
- Gender REQUIRED Female Male Please fill out this field.
- Ethnicity REQUIRED
  For statistical purposes only.
  Hispanic/Latino/Spanish Origin Black/African-American Asian/Pacific Islander White/Other Please fill out this field.
- Primary Language REQUIRED
  For statistical purposes only.
  English Spanish French Other Please fill out this field.
- Faith REQUIRED Roman Catholic Other Christian * Muslim Jewish Other * No Affiliation Please fill out this field.
- * Please Specify Please enter valid data.
- Sacraments Received - Select all completed Baptism Reconciliation Eucharist Confirmation
- Marital Status REQUIRED Unmarried Married - Catholic Married - civil Please fill out this field.
- Name of Church (if applicable) Please enter valid data.
- City/State of Marriage Please enter valid data.
- Date of Marriage Please enter valid data.
- Employment Information Employed Not employed outside the home Retired Full-time student
- Occupation Please enter valid data.
- Employer Name Please enter valid data.
- Street Address Please enter valid data.
- City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
- Spouse First Name Please enter valid data.
- Spouse Nickname Please enter valid data.
- Spouse Middle Name Please enter valid data.
- Spouse Last Name/Surname Please enter valid data.
- Date of Birth Please enter a date.
- Email Please enter an email address.
- Phone Number Maximum 20 characters Please enter a phone number.
- How would you like to be contacted by the Welcoming Committee? Text Call Email
- Ethnicity
  For statistical purposes only.
  Hispanic/Latino/Spanish Origin Black/African-American Asian/Pacific Islander White/Other
- Primary Language
  For statistical purposes only.
  English Spanish French Other
- Faith Roman Catholic Other Christian * Muslim Jewish Other * No Affiliation
- * Please Specify Please enter valid data.
- Sacraments Received - Select all completed Baptism Reconciliation Eucharist Confirmation
- Employment Information Employed Not employed outside the home Retired Full-time student
- Occupation Please enter valid data.
- Employer Name Please enter valid data.
- Street Address Please enter valid data.
- City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
- How many children do you have? REQUIRED Please fill out this field.
  
  Child 1
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Nickname Please enter valid data.
  
  Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name/Surname REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Female Male Please fill out this field.
  
  Ethnicity REQUIRED
  For statistical purposes only.
  Hispanic/Latino/Spanish Origin Black/African-American Asian/Pacific Islander White/Other Please fill out this field.
  
  Primary Language REQUIRED
  For statistical purposes only.
  English Spanish French Other Please fill out this field.
  
  Sacraments Received - Select all completed REQUIRED Baptism Reconciliation Eucharist Confirmation Please fill out this field.
  
  School REQUIRED St. Edward Blessed Maria Columbus High School PK Blessed Sacrament Public School Home School NA Please fill out this field.
  
  Grade REQUIRED Please fill out this field. Please enter valid data.
  
  Child 2
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Nickname Please enter valid data.
  
  Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name/Surname REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Female Male Please fill out this field.
  
  Ethnicity REQUIRED
  For statistical purposes only.
  Hispanic/Latino/Spanish Origin Black/African-American Asian/Pacific Islander White/Other Please fill out this field.
  
  Primary Language REQUIRED
  For statistical purposes only.
  English Spanish French Other Please fill out this field.
  
  Sacraments Received - Select all completed REQUIRED Baptism Reconciliation Eucharist Confirmation Please fill out this field.
  
  School REQUIRED St. Edward Blessed Maria Columbus High School PK Blessed Sacrament Public School Home School NA Please fill out this field.
  
  Grade REQUIRED Please fill out this field. Please enter valid data.
  
  Child 3
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Nickname Please enter valid data.
  
  Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name/Surname REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Female Male Please fill out this field.
  
  Ethnicity REQUIRED
  For statistical purposes only.
  Hispanic/Latino/Spanish Origin Black/African-American Asian/Pacific Islander White/Other Please fill out this field.
  
  Primary Language REQUIRED
  For statistical purposes only.
  English Spanish French Other Please fill out this field.
  
  Sacraments Received - Select all completed REQUIRED Baptism Reconciliation Eucharist Confirmation Please fill out this field.
  
  School REQUIRED St. Edward Blessed Maria Columbus High School PK Blessed Sacrament Public School Home School NA Please fill out this field.
  
  Grade REQUIRED Please fill out this field. Please enter valid data.
  
  Child 4
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Nickname Please enter valid data.
  
  Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name/Surname REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Female Male Please fill out this field.
  
  Ethnicity REQUIRED
  For statistical purposes only.
  Hispanic/Latino/Spanish Origin Black/African-American Asian/Pacific Islander White/Other Please fill out this field.
  
  Primary Language REQUIRED
  For statistical purposes only.
  English Spanish French Other Please fill out this field.
  
  Sacraments Received - Select all completed REQUIRED Baptism Reconciliation Eucharist Confirmation Please fill out this field.
  
  School REQUIRED St. Edward Blessed Maria Columbus High School PK Blessed Sacrament Public School Home School NA Please fill out this field.
  
  Grade REQUIRED Please fill out this field. Please enter valid data.
  
  Child 5
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Nickname Please enter valid data.
  
  Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name/Surname REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Female Male Please fill out this field.
  
  Ethnicity REQUIRED
  For statistical purposes only.
  Hispanic/Latino/Spanish Origin Black/African-American Asian/Pacific Islander White/Other Please fill out this field.
  
  Primary Language REQUIRED
  For statistical purposes only.
  English Spanish French Other Please fill out this field.
  
  Sacraments Received - Select all completed REQUIRED Baptism Reconciliation Eucharist Confirmation Please fill out this field.
  
  School REQUIRED St. Edward Blessed Maria Columbus High School PK Blessed Sacrament Public School Home School NA Please fill out this field.
  
  Grade REQUIRED Please fill out this field. Please enter valid data.
  
  Child 6
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Nickname Please enter valid data.
  
  Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name/Surname REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Female Male Please fill out this field.
  
  Ethnicity REQUIRED
  For statistical purposes only.
  Hispanic/Latino/Spanish Origin Black/African-American Asian/Pacific Islander White/Other Please fill out this field.
  
  Primary Language REQUIRED
  For statistical purposes only.
  English Spanish French Other Please fill out this field.
  
  Sacraments Received - Select all completed REQUIRED Baptism Reconciliation Eucharist Confirmation Please fill out this field.
  
  School REQUIRED St. Edward Blessed Maria Columbus High School PK Blessed Sacrament Public School Home School NA Please fill out this field.
  
  Grade REQUIRED Please fill out this field. Please enter valid data.
  
  Child 7
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Nickname Please enter valid data.
  
  Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name/Surname REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Female Male Please fill out this field.
  
  Ethnicity REQUIRED
  For statistical purposes only.
  Hispanic/Latino/Spanish Origin Black/African-American Asian/Pacific Islander White/Other Please fill out this field.
  
  Primary Language REQUIRED
  For statistical purposes only.
  English Spanish French Other Please fill out this field.
  
  Sacraments Received - Select all completed REQUIRED Baptism Reconciliation Eucharist Confirmation Please fill out this field.
  
  School REQUIRED St. Edward Blessed Maria Columbus High School PK Blessed Sacrament Public School Home School NA Please fill out this field.
  
  Grade REQUIRED Please fill out this field. Please enter valid data.
  
  Child 8
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Nickname Please enter valid data.
  
  Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name/Surname REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Female Male Please fill out this field.
  
  Ethnicity REQUIRED
  For statistical purposes only.
  Hispanic/Latino/Spanish Origin Black/African-American Asian/Pacific Islander White/Other Please fill out this field.
  
  Primary Language REQUIRED
  For statistical purposes only.
  English Spanish French Other Please fill out this field.
  
  Sacraments Received - Select all completed REQUIRED Baptism Reconciliation Eucharist Confirmation Please fill out this field.
  
  School REQUIRED St. Edward Blessed Maria Columbus High School PK Blessed Sacrament Public School Home School NA Please fill out this field.
  
  Grade REQUIRED Please fill out this field. Please enter valid data.
  
  Child 9
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Nickname Please enter valid data.
  
  Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name/Surname REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Female Male Please fill out this field.
  
  Ethnicity REQUIRED
  For statistical purposes only.
  Hispanic/Latino/Spanish Origin Black/African-American Asian/Pacific Islander White/Other Please fill out this field.
  
  Primary Language REQUIRED
  For statistical purposes only.
  English Spanish French Other Please fill out this field.
  
  Sacraments Received - Select all completed REQUIRED Baptism Reconciliation Eucharist Confirmation Please fill out this field.
  
  School REQUIRED St. Edward Blessed Maria Columbus High School PK Blessed Sacrament Public School Home School NA Please fill out this field.
  
  Grade REQUIRED Please fill out this field. Please enter valid data.
  
  Child 10
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Nickname Please enter valid data.
  
  Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name/Surname REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Female Male Please fill out this field.
  
  Ethnicity REQUIRED
  For statistical purposes only.
  Hispanic/Latino/Spanish Origin Black/African-American Asian/Pacific Islander White/Other Please fill out this field.
  
  Primary Language REQUIRED
  For statistical purposes only.
  English Spanish French Other Please fill out this field.
  
  Sacraments Received - Select all completed REQUIRED Baptism Reconciliation Eucharist Confirmation Please fill out this field.
  
  School REQUIRED St. Edward Blessed Maria Columbus High School PK Blessed Sacrament Public School Home School NA Please fill out this field.
  
  Grade REQUIRED Please fill out this field. Please enter valid data.
  
  Child 11
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Nickname Please enter valid data.
  
  Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name/Surname REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Female Male Please fill out this field.
  
  Ethnicity REQUIRED
  For statistical purposes only.
  Hispanic/Latino/Spanish Origin Black/African-American Asian/Pacific Islander White/Other Please fill out this field.
  
  Primary Language REQUIRED
  For statistical purposes only.
  English Spanish French Other Please fill out this field.
  
  Sacraments Received - Select all completed REQUIRED Baptism Reconciliation Eucharist Confirmation Please fill out this field.
  
  School REQUIRED St. Edward Blessed Maria Columbus High School PK Blessed Sacrament Public School Home School NA Please fill out this field.
  
  Grade REQUIRED Please fill out this field. Please enter valid data.
  
  Child 12
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Nickname Please enter valid data.
  
  Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name/Surname REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Female Male Please fill out this field.
  
  Ethnicity REQUIRED
  For statistical purposes only.
  Hispanic/Latino/Spanish Origin Black/African-American Asian/Pacific Islander White/Other Please fill out this field.
  
  Primary Language REQUIRED
  For statistical purposes only.
  English Spanish French Other Please fill out this field.
  
  Sacraments Received - Select all completed REQUIRED Baptism Reconciliation Eucharist Confirmation Please fill out this field.
  
  School REQUIRED St. Edward Blessed Maria Columbus High School PK Blessed Sacrament Public School Home School NA Please fill out this field.
  
  Grade REQUIRED Please fill out this field. Please enter valid data.
  
  Child 13
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Nickname Please enter valid data.
  
  Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name/Surname REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Female Male Please fill out this field.
  
  Ethnicity REQUIRED
  For statistical purposes only.
  Hispanic/Latino/Spanish Origin Black/African-American Asian/Pacific Islander White/Other Please fill out this field.
  
  Primary Language REQUIRED
  For statistical purposes only.
  English Spanish French Other Please fill out this field.
  
  Sacraments Received - Select all completed REQUIRED Baptism Reconciliation Eucharist Confirmation Please fill out this field.
  
  School REQUIRED St. Edward Blessed Maria Columbus High School PK Blessed Sacrament Public School Home School NA Please fill out this field.
  
  Grade REQUIRED Please fill out this field. Please enter valid data.
  
  Child 14
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Nickname Please enter valid data.
  
  Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name/Surname REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Female Male Please fill out this field.
  
  Ethnicity REQUIRED
  For statistical purposes only.
  Hispanic/Latino/Spanish Origin Black/African-American Asian/Pacific Islander White/Other Please fill out this field.
  
  Primary Language REQUIRED
  For statistical purposes only.
  English Spanish French Other Please fill out this field.
  
  Sacraments Received - Select all completed REQUIRED Baptism Reconciliation Eucharist Confirmation Please fill out this field.
  
  School REQUIRED St. Edward Blessed Maria Columbus High School PK Blessed Sacrament Public School Home School NA Please fill out this field.
  
  Grade REQUIRED Please fill out this field. Please enter valid data.
  
  Child 15
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Nickname Please enter valid data.
  
  Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name/Surname REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Female Male Please fill out this field.
  
  Ethnicity REQUIRED
  For statistical purposes only.
  Hispanic/Latino/Spanish Origin Black/African-American Asian/Pacific Islander White/Other Please fill out this field.
  
  Primary Language REQUIRED
  For statistical purposes only.
  English Spanish French Other Please fill out this field.
  
  Sacraments Received - Select all completed REQUIRED Baptism Reconciliation Eucharist Confirmation Please fill out this field.
  
  School REQUIRED St. Edward Blessed Maria Columbus High School PK Blessed Sacrament Public School Home School NA Please fill out this field.
  
  Grade REQUIRED Please fill out this field. Please enter valid data.
  
  Child 16
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Nickname Please enter valid data.
  
  Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name/Surname REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Female Male Please fill out this field.
  
  Ethnicity REQUIRED
  For statistical purposes only.
  Hispanic/Latino/Spanish Origin Black/African-American Asian/Pacific Islander White/Other Please fill out this field.
  
  Primary Language REQUIRED
  For statistical purposes only.
  English Spanish French Other Please fill out this field.
  
  Sacraments Received - Select all completed REQUIRED Baptism Reconciliation Eucharist Confirmation Please fill out this field.
  
  School REQUIRED St. Edward Blessed Maria Columbus High School PK Blessed Sacrament Public School Home School NA Please fill out this field.
  
  Grade REQUIRED Please fill out this field. Please enter valid data.
  
  Child 17
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Nickname Please enter valid data.
  
  Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name/Surname REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Female Male Please fill out this field.
  
  Ethnicity REQUIRED
  For statistical purposes only.
  Hispanic/Latino/Spanish Origin Black/African-American Asian/Pacific Islander White/Other Please fill out this field.
  
  Primary Language REQUIRED
  For statistical purposes only.
  English Spanish French Other Please fill out this field.
  
  Sacraments Received - Select all completed REQUIRED Baptism Reconciliation Eucharist Confirmation Please fill out this field.
  
  School REQUIRED St. Edward Blessed Maria Columbus High School PK Blessed Sacrament Public School Home School NA Please fill out this field.
  
  Grade REQUIRED Please fill out this field. Please enter valid data.
  
  Child 18
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Nickname Please enter valid data.
  
  Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name/Surname REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Female Male Please fill out this field.
  
  Ethnicity REQUIRED
  For statistical purposes only.
  Hispanic/Latino/Spanish Origin Black/African-American Asian/Pacific Islander White/Other Please fill out this field.
  
  Primary Language REQUIRED
  For statistical purposes only.
  English Spanish French Other Please fill out this field.
  
  Sacraments Received - Select all completed REQUIRED Baptism Reconciliation Eucharist Confirmation Please fill out this field.
  
  School REQUIRED St. Edward Blessed Maria Columbus High School PK Blessed Sacrament Public School Home School NA Please fill out this field.
  
  Grade REQUIRED Please fill out this field. Please enter valid data.
  
  Child 19
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Nickname Please enter valid data.
  
  Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name/Surname REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Female Male Please fill out this field.
  
  Ethnicity REQUIRED
  For statistical purposes only.
  Hispanic/Latino/Spanish Origin Black/African-American Asian/Pacific Islander White/Other Please fill out this field.
  
  Primary Language REQUIRED
  For statistical purposes only.
  English Spanish French Other Please fill out this field.
  
  Sacraments Received - Select all completed REQUIRED Baptism Reconciliation Eucharist Confirmation Please fill out this field.
  
  School REQUIRED St. Edward Blessed Maria Columbus High School PK Blessed Sacrament Public School Home School NA Please fill out this field.
  
  Grade REQUIRED Please fill out this field. Please enter valid data.
  
  Child 20
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Nickname Please enter valid data.
  
  Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name/Surname REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Female Male Please fill out this field.
  
  Ethnicity REQUIRED
  For statistical purposes only.
  Hispanic/Latino/Spanish Origin Black/African-American Asian/Pacific Islander White/Other Please fill out this field.
  
  Primary Language REQUIRED
  For statistical purposes only.
  English Spanish French Other Please fill out this field.
  
  Sacraments Received - Select all completed REQUIRED Baptism Reconciliation Eucharist Confirmation Please fill out this field.
  
  School REQUIRED St. Edward Blessed Maria Columbus High School PK Blessed Sacrament Public School Home School NA Please fill out this field.
  
  Grade REQUIRED Please fill out this field. Please enter valid data.
- Ministry and/or committee involvement - see "Get Involved" tab on the website.
- Sacrificial Giving Preference REQUIRED EFT - Authorization form available on the Share My Gifts tab Envelopes Please fill out this field.
- Additional Information
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St. Edward Catholic Church

1423 Kimball Avenue, Waterloo, IA 50702 319-233-8060

The Mission of St. Edward Church is to be
an evangelizing community
by faith, with love, in hope.

Join Us!

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