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Join our Parish

- St. Bernadette Parish Registration Form
  
  Thank you for your interest in joining our St. Bernadette Parish Family. This form covers contact and sacrament information for the adults and children in your family. If any of the questions do not pertain to you or your family members, please feel free to leave it blank.
- The maximum number of form submissions has been reached. This form is currently not available.
  
  Date REQUIRED Please fill out this field. Please enter a date.
  
  Family Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Address REQUIRED Please fill out this field.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Family Email Address Please enter valid data.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Previous Parish Name, City / State
  
  INTERESTS
  
  What attracted you to St. Bernadette Parish?
  
  What are you interested in? Baptism Marriage Small Group Opportunities Faith Formation Classes Other
  
  Please explain
  
  Adult and Children Member Information
  
  Please provide information about members of the family who will be joining the parish.
  
  1st Member Joining the Parish (first and last name) REQUIRED Please fill out this field. Please enter valid data.
  
  Birthday REQUIRED Please fill out this field. Please enter a date.
  
  Cell Phone Maximum 20 characters Please enter a phone number.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Occupation/Place of Employment (Adults) / Name of School and Grade (Student)
  
  What are your hobbies or interests?
  
  Will this person be active at St. Bernadette Parish? yes no
  
  Has this person received the Sacrament of Baptism? yes no
  
  Submit
  
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