Apply to Attend

Please fill out and submit the form below to apply for any of the Bernadette’s House program offerings. If you have any questions or trouble with the form, please call 410-707-2420.

Parent Name *
Parent Name
Name of Child (who will be attending) *
Name of Child (who will be attending)
Phone *
Phone
Checkbox *
Check any program that you are interested in registering or learning more about.