Register as a new Parishioner

Thank you for your interested in joining St. Bernard Catholic Church in Wamego, KS or St. Joseph Church in Flush, KS. You may either fill out this online form, or print the above form and mail it, place it in the collection basket or bring it to the church office. Please contact Carol with questions at (785) 456-7869 or stbernard66547@gmail.com.

Which parish would you like to join? REQUIRED St. Bernard, Wamego St. Joseph, Flush Please fill out this field.

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

Primary Contact REQUIRED Please fill out this field. Please enter valid data.

Primary Contact Email Address REQUIRED Please fill out this field. Please enter valid data.

Address, City, State, Zip Code REQUIRED Please fill out this field. Please enter valid data.

Home Phone Please enter valid data.

Husband Cell Please enter valid data.

Wife Cell Please enter valid data.

Marital Status

Anniversary Date Please enter valid data.

How many members of your family? REQUIRED
Please fill out for all your family starting with the parents and then children.
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.
- Role in Family REQUIRED Please fill out this field.
- Occupation or Grade Level Please enter valid data.
- Religion REQUIRED Please fill out this field. Please enter valid data.
- What Sacraments has this family member received? Baptism First Eucharist Confirmation
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.
- Role in Family REQUIRED Please fill out this field.
- Occupation or Grade Level Please enter valid data.
- Religion REQUIRED Please fill out this field. Please enter valid data.
- What Sacraments has this family member received? Baptism First Eucharist Confirmation
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.
- Role in Family REQUIRED Please fill out this field.
- Occupation or Grade Level Please enter valid data.
- Religion REQUIRED Please fill out this field. Please enter valid data.
- What Sacraments has this family member received? Baptism First Eucharist Confirmation
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.
- Role in Family REQUIRED Please fill out this field.
- Occupation or Grade Level Please enter valid data.
- Religion REQUIRED Please fill out this field. Please enter valid data.
- What Sacraments has this family member received? Baptism First Eucharist Confirmation
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.
- Role in Family REQUIRED Please fill out this field.
- Occupation or Grade Level Please enter valid data.
- Religion REQUIRED Please fill out this field. Please enter valid data.
- What Sacraments has this family member received? Baptism First Eucharist Confirmation
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.
- Role in Family REQUIRED Please fill out this field.
- Occupation or Grade Level Please enter valid data.
- Religion REQUIRED Please fill out this field. Please enter valid data.
- What Sacraments has this family member received? Baptism First Eucharist Confirmation
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.
- Role in Family REQUIRED Please fill out this field.
- Occupation or Grade Level Please enter valid data.
- Religion REQUIRED Please fill out this field. Please enter valid data.
- What Sacraments has this family member received? Baptism First Eucharist Confirmation