St. Bernadette Parish Registration Form

Please complete all fields and be sure to hit "submit" at the end of the form.

Parish Use Only:

General Information

Family Name *

Home phone number *

Primary family cell phone *

Primary Family Email Address This email address will be added to our Parish News distribution list, which is used to inform parishioners of important announcements, including closings and schedule changes. If you would like to opt out of these emails, please contact the front office. *

Street Address *

Address Line 2

City *

State *

Zip Code *

How would you like to contribute to the parish? *

I would like to contribute using online giving.

I would like to contribute using debit donation.

I would like to contribute using parish envelopes.

Would you like to receive the Catholic Review? *

Yes

No

Family Members

Head of Household

First Name *

Maidan Name (if applicable)

Last Name *

Date of Birth * +

Gender *

Male

Female

Occupation & Employer *

Language(s) Spoken *

Religion *

Sacraments Received *

Co-Head of Household/Second Adult

First Name

Maidan name (if applicable)

Legal last name

Date of Birth +

Gender

Male

Female

Occupation & Employer (please enter NA if not applicable)

Language(s) Spoken

Religion

Sacraments Received

Children Under the Age of 25 Living at Home

Please complete this information only for children living at home who have not yet turned 25. Older children or other adults living in the household should complete a separate registration form.

	Child #1	Child #2	Child #3
Child's Full Name	Child #1	Child #2	Child #3
Child's Preferred Name	Child #1	Child #2	Child #3
Child's Date of Birth	Child #1	Child #2	Child #3
Child's Gender (M/F)	Child #1	Child #2	Child #3
Child's Current Grade & School	Child #1	Child #2	Child #3
Child's Religion	Child #1	Child #2	Child #3
Language(s) Child Speaks	Child #1	Child #2	Child #3

(Continued for additional children if necessary. If you have more than 6 children, please contact the front office to provide the additional information.)

	Child #4	Child #5	Child #6
Child's Full Name	Child #4	Child #5	Child #6
Child's Preferred Name	Child #4	Child #5	Child #6
Child's Date of Birth	Child #4	Child #5	Child #6
Child's Gender (M/F)	Child #4	Child #5	Child #6
Child's Current Grade & School	Child #4	Child #5	Child #6
Child's Religion	Child #4	Child #5	Child #6
Language(s) Child Speaks	Child #4	Child #5	Child #6

Sacraments Received by the Children Above

	Child #1	Child #2	Child #3	Child #4	Child #5	Child #6
Baptism	Child #1	Child #2	Child #3	Child #4	Child #5	Child #6
Reconciliation (prep)	Child #1	Child #2	Child #3	Child #4	Child #5	Child #6
Eucharist	Child #1	Child #2	Child #3	Child #4	Child #5	Child #6
Confirmation	Child #1	Child #2	Child #3	Child #4	Child #5	Child #6

Your Place in the Community

Linked Households

Is there anyone at the parish who is a relative or friend? Let us know with whom and how you are connected here:

What Are Your Interests & Gifts?

Please select any ministries and/or parish organizations you, or your family members, would like to learn more about... *

Please identify any skills or interests that you may be able to use to volunteer for the parish: *

How Can We Help You?

Is there anything your family currently needs?

Is there anything else you would like us to know about you or your family?

Creating Community	Seniors Club
Women's Club	Development & Finance Committee
Adult Faith Formation	Divorced/Separated Ministry
Rite of Christian Initiation of Adults (RCIA)	Early Childhood Religious Education Instructor/Assistant
Elementary Religious Education Instructor/Assistant	Middle School Faith Formation Team Member
High School Faith Formation Team Member	Facilities Committee
Bereavement Ministry	Pastoral Visitors (Visits sick/homebound parishioners)
Justice & Peace Committee	Helping Neighbors (small repair assistance)
Winter Homeless Shelter	Knights of Columbus
Liturgy Committee	Altar Servers
Liturgical Environment	Extraordinary Ministers of Holy Communion
Lectors	Sacristans/Mass Coordinators
Ushers & Greeters	Family Events
Adult Choir	Cantors
Children's Choir	Instrumentalists
Teen Choir	Youth Ministry
Youth Ministry Adult Team	Baltimore-Appalachia Workcamp
NONE AT THIS TIME	Other: Other:

Advertising/Marketing	Baking	Carpentry
Cleaning	Communications	Cooking
Decorating	Electrical	Fundraising
Gardening	Graphic Design	Information Technology
Interior Design	Marketing	Office Help
Painting	Plumbing	Photography
Security	NONE AT THIS TIME	Other Other