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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.
- Middle Name REQUIRED Please fill out this field. Please enter valid data.
- Last Name 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 Please fill out this field. Please enter a phone number.
- 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 Middle Name Please enter valid data.
- Spouse Last Name Please enter valid data.
- Date of Birth Please enter a date.
- Email Please enter an email address.
- Phone Number Please enter a phone number.
- Ethnicity
  For statistical purposes only.
  Hispanic/Latino/Spanish Origin Black/African-American Asian/Pacific Islander White/Other
- Primary Language REQUIRED
  For statistical purposes only.
  English Spanish French Other Please fill out this field.
- 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.
- Child #1 First Name Please enter valid data.
- Child #1 Middle Name Please enter valid data.
- Child #1 Last Name Please enter valid data.
- Date of Birth Please enter a date.
- Gender Female Male
- Ethnicity
  For statistical purposes only.
  Hispanic/Latino/Spanish Origin Black/African-American Asian/Pacific Islander White/Other
- Primary Language REQUIRED
  For statistical purposes only.
  English Spanish French Other Please fill out this field.
- Sacraments Received - Select all completed Baptism Reconciliation Eucharist Confirmation
- School Please enter valid data.
- Grade Please enter valid data.
- Child #2 First Name Please enter valid data.
- Child #2 Middle Name Please enter valid data.
- Child #2 Last Name Please enter valid data.
- Date of Birth Please enter a date.
- Gender Female Male
- Ethnicity
  For statistical purposes only.
  Hispanic/Latino/Spanish Origin Black/African-American Asian/Pacific Islander White/Other
- Primary Language REQUIRED
  For statistical purposes only.
  English Spanish French Other Please fill out this field.
- Sacraments Received - Select all completed Baptism Reconciliation Eucharist Confirmation
- School Please enter valid data.
- Grade Please enter valid data.
- Child #3 First Name Please enter valid data.
- Child #3 Middle Name Please enter valid data.
- Child #3 Last Name Please enter valid data.
- Date of Birth Please enter a date.
- Gender Female Male
- Ethnicity
  For statistical purposes only.
  Hispanic/Latino/Spanish Origin Black/African-American Asian/Pacific Islander White/Other
- Primary Language REQUIRED
  For statistical purposes only.
  English Spanish French Other Please fill out this field.
- Sacraments Recieved - Select all completed Baptism Reconciliation Eucharist Confirmation
- School Please enter valid data.
- Grade Please enter valid data.
- Ministry and/or committee involvement - see "Get Involved" tab on the website.
- Sacrificial Giving Preference EFT - you will be contacted to provide signed form and voided check Envelopes
- 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!

Parish Registration Form