Event Registration

Please complete this form for each participant

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

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

Participant's Birth Date REQUIRED Please fill out this field. Please enter a date.

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

Is family registered as members of St. Joseph North Bend? REQUIRED Yes No Please fill out this field.

If YES, what family name was used for your registration? Please enter valid data.

If NO, parish registration is necessary to maintain sacramental records. Please see registration form on the sidebar of this page to complete registration process.

Primary Contact

Who will be the primary contact during the summer program? REQUIRED Please fill out this field. Please enter valid data.
Primary contact's relationship to child REQUIRED Mother Father Grandparent Please fill out this field.
Address of Primary Contact 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.
Primary Contact's Mobile Phone Number Please enter a phone number.
Primary Contact's Home Phone REQUIRED Please fill out this field. Please enter a phone number.
Primary Contact's Email REQUIRED Please fill out this field. Please enter an email address.

Emergency Contact

Name of Emergency Contact REQUIRED Please fill out this field. Please enter valid data.
Emergency Contact's Relationship to Child REQUIRED Please fill out this field. Please enter valid data.
Emergency Contact's Mobile Phone Number Please enter a phone number.
Emergency Contact's Home Phone REQUIRED Please fill out this field. Please enter a phone number.
Emergency Contact's Email REQUIRED Please fill out this field. Please enter an email address.

Event Registration

For New Parishioners

Registration Documents

Registration Links:

Contact for Registration Info

Summer Program Registration

Medical Release Required

CLICK HERE FOR MEDICAL RELEASE FORM TO PRINT AND COMPLETE

Payment Information