Baptism Registration Form
Location Preference
*
Please Select
St. Mary's, Swormville
St Teresa of Avila, Akron
Nativity of the Blessed Virgin Mary, Williamsville
Our Lady of Peace, Clarence
Sacred Heart of Jesus, Bowmansville
Child's Information:
Child's Full Name
*
First Name
Middle Name
Last Name
Child's Gender
*
Male
Female
Child's Date of Birth / Due Date
*
/
Month
/
Day
Year
Date
Place of Birth
*
Place 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 Number
*
Mother's Email
*
example@example.com
Religion of Mother
*
Father's Name
*
First Name
Middle Name
Last Name
Father's Cell Phone Number
*
Father's Email
*
example@example.com
Religion of Father
*
Are parents married?
Yes
No
Have you attended Baptism Class?
*
Yes we have attended baptism class in the past 2 years
Not yet scheduled
Scheduled, but not yet attended
Godparent's Information
PLEASE NOTE: Godparent Validation Form(s) are to be turned into the Faith Formation Office at 6919 Transit Road PRIOR TO SCHEDULING THE BAPTISM.
Godmother's Name
First Name
Middle Name
Last Name
Is this person a practicing Catholic?
Yes
No
Is this person a parishioner of our Family of Parishes (ACRCC)?
Yes
No
Name and Location of home parish
Godfather's Name
First Name
Middle Name
Last Name
Is this person a practicing Catholic?
Yes
No
Is this person a parishioner of our Family of Parishes (ACRCC)?
Yes
No
Name and Location of home parish
Will either Godparent be represented by a proxy?
Yes, one
Yes, both
No
Is the child adopted?
Yes
No
Disclaimer
I hearby grant permission for publication of group (two or more persons) photo(s) and videos taken at church events to be used at church publications only. I've read the terms above and:
I agree
I disagree
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