Registration

Need to register at Our Lady of the Black Hills for the first time? Or simply need to update some contact information from a previous registration? Fill out the form below to help us keep your information current!


* Indicates required fields

Registration Type:* New Member RegistrationUpdated Current Member Information

Catholic Head of Household
First Name:*

Last Name:*

Birth Date: (yyyy-mm-dd)

Religion:*

Mobile #:

Work #:

Email:
Spouse
First Name:

Last Name:

Birth Date: (yyyy-mm-dd)

Religion:

Mobile #:

Work #:

Email:


Mailing Address including City State and Zip:*
Physical Address (if different):
Winter Address (if applicable):


Home Phone:
Unlisted
Mobile Phone (if applicable):
Unlisted


Marriage Status:*
SingleMarriedWidowedDivorcedCohabitating

Marriage Date:

Marriage Type:
CatholicCivilOther Denomination

If non-Catholic marriage, has it been validated? YesNo

Do you want envelopes for parish contributions?* YesNo
Do you want information about automatic contributions?* YesNo

Please complete an entry for each child in the home. Other adults, not in school, are asked to register separately.

First Name:

Last Name:

Birth Date: (yyyy-mm-dd)

Religion:

School:

Grade:
First Name:

Last Name:

Birth Date: (yyyy-mm-dd)

Religion:

School:

Grade:
First Name:

Last Name:

Birth Date: (yyyy-mm-dd)

Religion:

School:

Grade:
First Name:

Last Name:

Birth Date: (yyyy-mm-dd)

Religion:

School:

Grade:


For each additional child in the family, please list their name, birth date, religion, school & grade on separate lines below, You can also include any comments/questions.