Registration

To register with Our Lady of Prompt Succor Parish, please complete all registration information below to the best of your knowledge. If you require additional space for extra children or adults, please complete an additional registration form. If the question does not apply to you, please leave it blank.

Your information will be sent directly to the Parish Office and is confidential. If you would rather register in person, please visit the Parish Office.

Parish Office
Mary Ann LeBlanc,
Administrative Assistant
[email protected]
Monday - Friday: 8:00am - 4:00 pm
Phone: (337) 527-5261
Fax: (337) 528-2991
1109 Cypress Street
Sulphur, Louisiana 70663

MAILING LABEL: (List husband & wife, if married)

Name REQUIRED Please fill out this field. Please enter valid data.

Address REQUIRED Please fill out this field. Please enter valid data.

Home Phone REQUIRED Please fill out this field. Please enter valid data.

Begin this section by registering the head of household first followed by spouse and dependent children. Please register all individuals in the household.

Example-1: If you are married with two kids, then select Husband as Registrant #1. Fill in husband's information, scroll down to Wife's section and complete her information, then scroll down to Children's section and complete those fields. After all household members have been entered, scroll to bottom of form and click Submit.

Example-2: If you are a divorced female with two kids, select Single Female (Head Household) as Registrant #1. Fill in your information in the first section, then scroll down to Children's section and complete those fields. After all household members have been entered, scroll to bottom of form and click Submit.

Registrant #1 REQUIRED Single Male (Head Household) Single Female (Head Household) Husband Please fill out this field.

Name REQUIRED Please fill out this field. Please enter valid data.

Email REQUIRED Please fill out this field. Please enter an email address.

Cell/Home Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Date of Birth REQUIRED

Date of Birth

Please fill out this field. Please enter a date.

Birth City REQUIRED

Note the city where you were born.

Please fill out this field. Please enter valid data.

Birth State REQUIRED

Where you were born.

Please fill out this field.

Are you Catholic? REQUIRED Yes No Please fill out this field.

Religion

If not Catholic, note religion here.

Please enter valid data.

Are you baptized? REQUIRED Yes No Please fill out this field.

Place of Baptism

If baptized, list the church and city/state where baptism took place.

Please enter valid data.

Marital Status REQUIRED Single Married Separated Divorced Please fill out this field.

Were you married by a priest?

If applicable, was your marriage ceremony officiated by a priest.

Yes No N/A

Employer Please enter valid data.

Occupation Please enter valid data.

This section to be completed with wife's information only, if applicable. To continue registering children, scroll down to next section.

Name of Wife Please enter valid data.

Email Please enter an email address.

Cell/Home Phone Number Please enter a phone number.

Date of Birth

Please enter a date.

Birth City

Note the city where you were born.

Please enter valid data.

Birth State

Where you were born.

Are you Catholic? Yes No

Religion

If not Catholic, note religion here.

Please enter valid data.

Are you baptized? Yes No

Place of Baptism

If baptized, list the church, city, and state where baptism took place.

Please enter valid data.

Marital Status Single Married Separated Divorced

Were you married by a priest?

If applicable, was your marriage ceremony officiated by a priest.

Yes No N/A

Maiden Name

If registering the wife, list her maiden name here.

Please enter valid data.

Employer Please enter valid data.

Occupation Please enter valid data.

This section to be completed with dependent child(ren)'s information only, if applicable. To continue registering other adults living in your household, scroll down to next section.

Name of Child #1 Please enter valid data.

Sex

Note whether child is male or female.

Male Female

Birthdate Please enter a date.

Religion Please enter valid data.

Baptized Yes No

Place of Baptism Please enter valid data.

Grade Please enter valid data.

School Please enter valid data.

Maiden Name of Mother Please enter valid data.

Name of Father Please enter valid data.

Name of Child #2 Please enter valid data.

Sex

Note whether child is male or female.

Male Female

Birthdate Please enter a date.

Religion Please enter valid data.

Baptized Yes No

Place of Baptism

Church, City, State

Please enter valid data.

Grade Please enter valid data.

School Please enter valid data.

Maiden Name of Mother Please enter valid data.

Name of Father Please enter valid data.

Name of Child #3 Please enter valid data.

Sex

Note whether child is male or female.

Male Female

Birthdate Please enter a date.

Religion Please enter valid data.

Baptized Yes No

Place of Baptism

Church, City, State

Please enter valid data.

Grade Please enter valid data.

School Please enter valid data.

Maiden Name of Mother Please enter valid data.

Name of Father Please enter valid data.

Name of Child #4 Please enter valid data.

Sex

Note whether child is male or female.

Male Female

Birthdate Please enter a date.

Religion Please enter valid data.

Baptized Yes No

Place of Baptism

Church, City, State

Please enter valid data.

Grade Please enter valid data.

School Please enter valid data.

Maiden Name of Mother Please enter valid data.

Name of Father Please enter valid data.

This section to be completed for other adults living in your household, if applicable.

Name of Other Adult #1 Please enter valid data.

Sex Male Female

Email Please enter an email address.

Cell/Home Phone Number Please enter a phone number.

Date of Birth Please enter a date.

Birth City Please enter valid data.

Birth State

Are you Catholic? Yes No

Religion (if not Catholic) Please enter valid data.

Are you baptized? Yes No

Place of Baptism Please enter valid data.

Marital Status Single Married Separated Divorced

Maiden Name Please enter valid data.

Employer Please enter valid data.

Occupation Please enter valid data.

Name of Other Adult #2 Please enter valid data.

Sex Male Female

Email Please enter an email address.

Cell/Home Phone Number Please enter a phone number.

Date of Birth Please enter a date.

Birth City Please enter valid data.

Birth State

Are you Catholic? Yes No

Are you baptized? Yes No

Place of Baptism Please enter valid data.

Marital Status Single Married Separated Divorced

Maiden Name Please enter valid data.

Employer Please enter valid data.

Occupation Please enter valid data.