Baptism Worksheet

Baptism Worksheet

For infants and young children desiring baptism at Saint Mary Catholic Church
Child's Full Name *
Male or Female *

Male Female
Date of Birth *

Month Day Year
Date
Place of Birth
City, State, Zip
Was the child adopted? *

Yes No
Was the child already baptized in an emergency? *

Yes No
Date

Month Day Year
Date
If baptized in an emergency, place of Baptism
City, State, Place(hospital name, home, etc...)
Father's Full Name *
Religion
Mother's Full Maiden Name *
Religion
Are the parents married? *

Yes No
Are parents married by a Catholic priest or deacon? *

Yes No
Address *

Address

Street Address Line 2

City

Zip
Phone
Cell
Please enter a valid phone number.
Email *
example@example.com
Are you a registered parishioner at St. Mary? *

Yes No
Date of registration

Month Day Year
Date
Catholic parent(s) must be REGISTERED and ACTIVE in the parish FOUR MONTHS prior to the Baptism. If the parents are not members of the parish, a letter from their pastor is required. A Baptism preparation class must be taken by the parents prior to the Baptism. Classes are online and will begin AFTER all paperwork and payment is completed.
Godparent's Information

At least one Godparent must be Catholic, have received First Holy Communion and Confirmation, attend Mass regularly and be 16 years of age or older. If the Godparent is married, he or she must have been married in the Catholic Church, with a priest or deacon officiating. NOTE: A separate form on the website MUST be completed if Godparent attends Saint Mary's. If Godparents attend another parish, mail or email their parish's Godparent form.
Is there a Godfather? *

Yes No
Name of Godfather
Please check that following that applies to the Godfather: *

Catholic 1st Holy Communion Confirmed Attends Mass Regulary is 16+ years old Single Married If married, married in the Catholic Church
Is there a Godmother? *

Yes No
Name of Godmother
Please check that following that applies to the Godmother: *

Catholic 1st Holy Communion Confirmed Attends Mass Regulary is 16+ years old Single Married If married, married in the Catholic Church
Will either Godparent be represented by a proxy?

Yes No
Name of Proxy/Proxies
Date Received

Month Day Year
Date
Date of Class

Month Day Year
Date
Scheduled Date for Baptism

Month Day Year
Date
Reviewed by
Date of Baptism

Month Day Year
Date
Certificate Sent
Entered in Book
Page
No
Should be Empty:

Baptism Worksheet

Godparent's Information