Facebook Twitter Instagram Flocknote YouTube

Registration

We are happy to welcome you to the Crozet Catholic Community at Our Lady of the Rosary. Please complete the online form below. The information will be submitted directly to our Parish Administrative Assistant. You may instead download the Welcome & Registration Packet and return the completed form by mail, email, collection basket at Mass or drop off at the OLR office. Note that all families wishing to enroll children in our Christian Formation Program must first be registered with the Parish by completing this form.

Please also sign up for Flocknote, our weekly email newsletter. See below. (Note: Signing up for Flocknote does not register you/your family in the Parish).

Please contact the office (434) 812-2936 with any questions.
Flocknote Signup (Signing up for Flocknote does not register you/your family in the parish)

First Name Last Name Email Address Phone
Success!
Documents
- Parish Welcome Packet (includes Registration Form, Ministry Descriptions .pdf)
- Parish Registration Form (.pdf)
Parish REGISTRATION FORM
The maximum number of form submissions has been reached. This form is currently not available.
- Registrant:
- Title Please enter valid data.
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- 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 REQUIRED Please fill out this field. Please enter an email address.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Home Phone Number Maximum 20 characters Please enter a phone number.
- Mobile Phone Number Maximum 20 characters Please enter a phone number.
- Work Phone Number Maximum 20 characters Please enter a phone number.
- Which is your preferred phone number? Home Mobile Work
- Were you previously registered with or currently active in another parish in the Richmond Diocese? REQUIRED
  Please check all that apply
  Yes No Please fill out this field.
- Other Parish Name and Location:
  Example: St. Thomas Aquinas, Charlottesville VA
  Please enter valid data.
- Religion REQUIRED
  Example: St. Thomas Aquinas, Charlottesville VA
  Please fill out this field. Please enter valid data.
- Sacraments Received REQUIRED
  Please check all that apply
  Baptism Communion Confirmation Catholic Marriage (Other Marriage) None Please fill out this field.
- I identify my ethnicity as:
  Select all that apply
  Asian Black/African American White/Caucasian Hispanic/Latino Native American Pacific Islander Prefer Not to Answer
- Primary Language Please enter valid data.
- Occupation (if applicable) Please enter valid data.
- How would you like to be involved? What ministries are you interested in?
- Please enter the number of other people who are presently residing in your home or temporarily away at college or military duty.
- Other Family Members REQUIRED
  How many other people are in your household?
  Please fill out this field.
  
  Family Member 1
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Relationship to Head of Household REQUIRED Spouse Child Other Please fill out this field.
  
  Email Please enter an email address.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  Sacraments Received REQUIRED Baptism Communion Confirmation Catholic Marriage (Other Marriage) None Please fill out this field.
  
  I identify my ethnicity as:
  Select all that apply
  Asian Black/African American White/Caucasian Hispanic/Latino Native American Pacific Islander Prefer Not to Answer
  
  School Name (if applicable) Please enter valid data.
  
  School Grade (if applicable) Please enter valid data.
  
  Occupation (if applicable) Please enter valid data.
  
  Primary Language Please enter valid data.
  
  Family Member 2
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Relationship to Head of Household REQUIRED Spouse Child Other Please fill out this field.
  
  Email Please enter an email address.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  Sacraments Received REQUIRED Baptism Communion Confirmation Catholic Marriage (Other Marriage) None Please fill out this field.
  
  I identify my ethnicity as:
  Select all that apply
  Asian Black/African American White/Caucasian Hispanic/Latino Native American Pacific Islander Prefer Not to Answer
  
  School Name (if applicable) Please enter valid data.
  
  School Grade (if applicable) Please enter valid data.
  
  Occupation (if applicable) Please enter valid data.
  
  Primary Language Please enter valid data.
  
  Family Member 3
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Relationship to Head of Household REQUIRED Spouse Child Other Please fill out this field.
  
  Email Please enter an email address.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  Sacraments Received REQUIRED Baptism Communion Confirmation Catholic Marriage (Other Marriage) None Please fill out this field.
  
  I identify my ethnicity as:
  Select all that apply
  Asian Black/African American White/Caucasian Hispanic/Latino Native American Pacific Islander Prefer Not to Answer
  
  School Name (if applicable) Please enter valid data.
  
  School Grade (if applicable) Please enter valid data.
  
  Occupation (if applicable) Please enter valid data.
  
  Primary Language Please enter valid data.
  
  Family Member 4
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Relationship to Head of Household REQUIRED Spouse Child Other Please fill out this field.
  
  Email Please enter an email address.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  Sacraments Received REQUIRED Baptism Communion Confirmation Catholic Marriage (Other Marriage) None Please fill out this field.
  
  I identify my ethnicity as:
  Select all that apply
  Asian Black/African American White/Caucasian Hispanic/Latino Native American Pacific Islander Prefer Not to Answer
  
  School Name (if applicable) Please enter valid data.
  
  School Grade (if applicable) Please enter valid data.
  
  Occupation (if applicable) Please enter valid data.
  
  Primary Language Please enter valid data.
  
  Family Member 5
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Relationship to Head of Household REQUIRED Spouse Child Other Please fill out this field.
  
  Email Please enter an email address.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  Sacraments Received REQUIRED Baptism Communion Confirmation Catholic Marriage (Other Marriage) None Please fill out this field.
  
  I identify my ethnicity as:
  Select all that apply
  Asian Black/African American White/Caucasian Hispanic/Latino Native American Pacific Islander Prefer Not to Answer
  
  School Name (if applicable) Please enter valid data.
  
  School Grade (if applicable) Please enter valid data.
  
  Occupation (if applicable) Please enter valid data.
  
  Primary Language Please enter valid data.
  
  Family Member 6
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Relationship to Head of Household REQUIRED Spouse Child Other Please fill out this field.
  
  Email Please enter an email address.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  Sacraments Received REQUIRED Baptism Communion Confirmation Catholic Marriage (Other Marriage) None Please fill out this field.
  
  I identify my ethnicity as:
  Select all that apply
  Asian Black/African American White/Caucasian Hispanic/Latino Native American Pacific Islander Prefer Not to Answer
  
  School Name (if applicable) Please enter valid data.
  
  School Grade (if applicable) Please enter valid data.
  
  Occupation (if applicable) Please enter valid data.
  
  Primary Language Please enter valid data.
  
  Family Member 7
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Relationship to Head of Household REQUIRED Spouse Child Other Please fill out this field.
  
  Email Please enter an email address.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  Sacraments Received REQUIRED Baptism Communion Confirmation Catholic Marriage (Other Marriage) None Please fill out this field.
  
  I identify my ethnicity as:
  Select all that apply
  Asian Black/African American White/Caucasian Hispanic/Latino Native American Pacific Islander Prefer Not to Answer
  
  School Name (if applicable) Please enter valid data.
  
  School Grade (if applicable) Please enter valid data.
  
  Occupation (if applicable) Please enter valid data.
  
  Primary Language Please enter valid data.
  
  Family Member 8
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Relationship to Head of Household REQUIRED Spouse Child Other Please fill out this field.
  
  Email Please enter an email address.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  Sacraments Received REQUIRED Baptism Communion Confirmation Catholic Marriage (Other Marriage) None Please fill out this field.
  
  I identify my ethnicity as:
  Select all that apply
  Asian Black/African American White/Caucasian Hispanic/Latino Native American Pacific Islander Prefer Not to Answer
  
  School Name (if applicable) Please enter valid data.
  
  School Grade (if applicable) Please enter valid data.
  
  Occupation (if applicable) Please enter valid data.
  
  Primary Language Please enter valid data.
  
  Family Member 9
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Relationship to Head of Household REQUIRED Spouse Child Other Please fill out this field.
  
  Email Please enter an email address.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  Sacraments Received REQUIRED Baptism Communion Confirmation Catholic Marriage (Other Marriage) None Please fill out this field.
  
  I identify my ethnicity as:
  Select all that apply
  Asian Black/African American White/Caucasian Hispanic/Latino Native American Pacific Islander Prefer Not to Answer
  
  School Name (if applicable) Please enter valid data.
  
  School Grade (if applicable) Please enter valid data.
  
  Occupation (if applicable) Please enter valid data.
  
  Primary Language Please enter valid data.
  
  Family Member 10
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Relationship to Head of Household REQUIRED Spouse Child Other Please fill out this field.
  
  Email Please enter an email address.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  Sacraments Received REQUIRED Baptism Communion Confirmation Catholic Marriage (Other Marriage) None Please fill out this field.
  
  I identify my ethnicity as:
  Select all that apply
  Asian Black/African American White/Caucasian Hispanic/Latino Native American Pacific Islander Prefer Not to Answer
  
  School Name (if applicable) Please enter valid data.
  
  School Grade (if applicable) Please enter valid data.
  
  Occupation (if applicable) Please enter valid data.
  
  Primary Language Please enter valid data.
  
  Family Member 11
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Relationship to Head of Household REQUIRED Spouse Child Other Please fill out this field.
  
  Email Please enter an email address.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  Sacraments Received REQUIRED Baptism Communion Confirmation Catholic Marriage (Other Marriage) None Please fill out this field.
  
  I identify my ethnicity as:
  Select all that apply
  Asian Black/African American White/Caucasian Hispanic/Latino Native American Pacific Islander Prefer Not to Answer
  
  School Name (if applicable) Please enter valid data.
  
  School Grade (if applicable) Please enter valid data.
  
  Occupation (if applicable) Please enter valid data.
  
  Primary Language Please enter valid data.
  
  Family Member 12
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Relationship to Head of Household REQUIRED Spouse Child Other Please fill out this field.
  
  Email Please enter an email address.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  Sacraments Received REQUIRED Baptism Communion Confirmation Catholic Marriage (Other Marriage) None Please fill out this field.
  
  I identify my ethnicity as:
  Select all that apply
  Asian Black/African American White/Caucasian Hispanic/Latino Native American Pacific Islander Prefer Not to Answer
  
  School Name (if applicable) Please enter valid data.
  
  School Grade (if applicable) Please enter valid data.
  
  Occupation (if applicable) Please enter valid data.
  
  Primary Language Please enter valid data.
- Anything we missed?
Submit

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
- About