Baptism Registration Form
Child's Name
*
First Name
Middle Name
Last Name
Child's Gender
*
Male
Female
Child's Date of Birth
*
/
Month
/
Day
Year
Date
Place of Birth
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Address Where Child Resides
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent's Information
Mother's Name
*
First Name
Middle Name
Last Name
Mother's Maiden Name
*
Mother's Cell Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Mother's Email
*
example@example.com
Religion of Mother
Father's Name
*
First Name
Middle Name
Last Name
Father's Cell Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Father's Email
*
example@example.com
Religion of Father
Are Parents Married?
*
Yes
No
Did you attend a Baptism Class?
*
Yes
No
Baptism Class Date
-
Month
-
Day
Year
Date
Godparent's Information
PLEASE NOTE: Godparent Validation Form(s) are to be turned into the Faith Formation Office PRIOR TO SCHEDULING THE BAPTISM.
Godmother's Name
First Name
Middle Name
Last Name
Catholic?
Yes
No
Parishioner of St. Mary's?
Yes
No
Name and Location of Home Parish
Godfather's Name
First Name
Middle Name
Last Name
Catholic?
Yes
No
Parishioner of St. Mary's?
Yes
No
Name and Location of Home Parish
Is either Godparent represented by Proxy?
Yes
No
Name of Proxy
First Name
Last Name
Is the Child Adopted?
*
Yes
No
Disclaimer
I hereby grant permission for publication of group (two or more persons) photo(s) and videos taken at church events to be used for church publications only. I've read the terms above and:
*
I agree
I disagree
Submit
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