St. Patrick Baptism Registration

Full Name of Child

First NameMiddle NameLast Name
City & State of Birth
Child's Date of Birth

MonthDayYear
Sex
Family's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Email
Home Phone
Format: (000) 000-0000.
Cell Phone
Format: (000) 000-0000.
Father's Full Name

First NameLast Name
Father's Religion
Mother's Full Maiden Name

First NameMaiden Name
Mother's Religion
Date of Marriage

MonthDayYear
Place of Marriage
Celebrant of Marriage
Parents who are not married must bring a copy of the child’s birth certificate to the rectory.
Number of Children (including child being baptized)
Number of Children previously Baptized at St. Patrick
Godparents Information
Godfather's Name

First NameLast Name
Godfather's Religion
Godmother's Name

First NameLast Name
Godmother's Religion
Godparents must be practicing Catholics who are (1) at least 16 years of age, (2) have received Communion and Confirmation, and (3) if married, are married in the Church. No exceptions can be made to these three points
Will either Godparent be represented by a Proxy? If a godparent is unable to attend the Baptism, a proxy must be named.
Name of Proxy
Was Child Previously Baptized?
Was Child Adopted? Copies of adoption papers must be brought to the rectory.
Should be Empty: