Sign up form for Memorial Mass and/or Reception

St. Stephen Catholic Church will host a Memorial Mass, also known as a Mass of Remembrance, in honor of our departed children. Please attend if you or someone you know has suffered the loss of a child. The Mass of Remembrance will be held in the main church at St. Stephen’s. Please see date(s) below. The Memorial Mass is often coordinated to follow Mercy Hospital's Early Infant Loss Burial Ceremony at St. Vincent de Paul's Cemetery.  See dates to confirm. Mass will begin at 6:00PM in the main church at St. Stephen's Catholic Church at 1300 NE J Street, Bentonville, AR 72712. Catholics and non-Catholics are welcome to join us!

A potluck reception will follow in the Parish Life Center.  If you're able to contribute to the potluck meal - that's great!  If you aren't able to contribute at this time, please join us anyway!

Please fill out this form if you'd like to RSVP, to add your child or children's names to the program and/or to volunteer to bring food to the reception.

What is Red Bird Ministries? Red Bird Ministries is a Catholic, pro-life, and pro-family grief support ministry that focuses on supporting individuals and couples who have experienced the loss of a child of any age and any circumstance including miscarriage, stillbirth, or after birth as an infant, child, adolescent, or adult.  Email Lauren McAdams with any questions redbird@ststephenbentonville.com


**If you would like to have your child or children's names included in the program for the Memorial Mass, please submit this form by the Wednesday before the scheduled service.
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Email *
Name of person filling out this form. *
Phone number  *
Please select the Memorial Mass and/or potluck are you RSVPing for:
 *
Required
Would you like your departed child or children's name(s) to be printed in the Memorial Mass program? 

If yes, please include full name and date of birth and passing, if different dates, for each child.  Please indicate if the child was lost due to miscarriage (lost before 20 weeks), still birth (lost after 20 weeks), infant loss (lost in first year of life), child lost (lost in childhood), adolescent loss, or adult child loss.

Please also include the name of the father and mother of the child. 

EXAMPLES:
Miscarriage example:
Catherine Francis McAdams
March 25, 2016 | 9 weeks in utero
Daughter of John and Lauren McAdams

Still Birth example:
Cayse Paul Leger
January 6, 2021
Stillborn
Son of Brennon and Ashley Leger

Infant Loss example:
Talon Antoine Breaux
October 16, 2005 to October 31, 2005
15 days old
Son of Ryan and Kelly Breaux

Child Loss example:
Emma Grace Breaux
October 16, 2005 to September 10. 2005
3 years 10 months old
Daughter of Ryan and Kelly Breaux

If you'd rather the child's name not be mentioned, write "no" below.
 *
Would you like a copy of the program mailed to you?  If so, please provide your complete address below and number of copies.
Would you like your departed child or children's name(s) to be announced at the beginning of the Memorial Mass?  If yes, please include full name for each child.  If no, write "no" below.
 *
Number of adults attending the reception and potluck. *
Number of children attending the reception and potluck. *
Bringing food to share at the potluck reception is optional. If you plan to bring something to share please indicate below.
A copy of your responses will be emailed to the address you provided.
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