Infant Baptism Form

Our Lady of Perpetual Help Church Request for Infant/Young Child Baptism
Family Name
Date

MonthDayYear
Date
Street
CityState
Zip
Phone Number*
Please enter a valid phone number.
Email*
Child's information
First Name
Middle
Last
Gender

MaleFemale
Date of Birth

MonthDayYear
Date
City State
Parents
First
Middle
Last
Religion
First
Middle
Maiden Name
Religion
Godparents
First
Middle
Last
Religion
First
Middle
Last
Religion
Birth Certificate

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Clergy you would like to perfom the Baptims
Baptism Request Agreement

By submitting this request and payment, I acknowledge and agree to the following:
- All the information I have provided is true and accurate to the best of my knowledge.
- I am a registered parishioner of Our Lady of Perpetual Help (OLPH) Parish.
- The Godparents selected have received all the Sacraments of Initiation: Baptism, Eucharist (First Communion), and Confirmation.
- Each Godparent is at least 16 years of age.
- If a Godparent is not a member of OLPH Parish, they must provide a letter from their home parish confirming that they are registered parishioners and have permission to serve as sponsors.
- Parents and Godparents are required to attend a pre-baptismal preparation class.
- I understand that the payment submitted is non-refundable.
Signature*

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