Baptism Worksheet

Baptism Worksheet

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

MaleFemale
Date of Birth or Due Date*

MonthDayYear
Date
Place of Birth
City, State, Zip
Was the child adopted?*

YesNo
Was the child already baptized in an emergency?*

YesNo
Date

MonthDayYear
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?*

YesNo
Are parents married by a Catholic priest or deacon?*

YesNo
Address*

Address

Street Address Line 2

CityState / Province

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

YesNo
Date of registration

MonthDayYear
Date
Catholic parent(s) must be REGISTERED and ACTIVE in the parish. 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. If Godparents attend another parish, mail or email their parish's Godparent form.
Is there a Godfather?*

YesNo
Name of Godfather
Please check that following that applies to the Godfather:*

Catholic1st Holy CommunionConfirmedAttends Mass Regularyis 16+ years oldSingleMarriedIf married, married in the Catholic Church
Is there a Godmother?*

YesNo
Name of Godmother
Please check that following that applies to the Godmother:*

Catholic1st Holy CommunionConfirmedAttends Mass Regularyis 16+ years oldSingleMarriedIf married, married in the Catholic Church
Will either Godparent be represented by a proxy?

YesNo
Name of Proxy/Proxies
Date Received

MonthDayYear
Date
Date of Class

MonthDayYear
Date
Scheduled Date for Baptism

MonthDayYear
Date
Reviewed by
Date of Baptism

MonthDayYear
Date
Certificate Sent
Entered in Book
Page
No
Should be Empty:

Baptism Worksheet

Godparent's Information