Full Name of Child
*
Date of Birth
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Father's Details
Father's Full Name
*
Father's Religion
*
Father's Home Address
*
Street Address
Street Address Line 2
City
State
Post Code
Father's Email
*
Father's Phone
*
Mother's Details
Mother's Full Name
*
Mother's Religion
*
Mother's Home Address
*
Street Address
Street Address Line 2
City
State
Post Code
Mother's Email
*
Mother's Phone
*
Godparents' Details
Godfather's Full Name
*
Godfather's Religion
*
Godmother's Full Name
*
Godmother's Religion
*
Proposed Date & Time of Baptism
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Baptism Requested by
*
Relationship to Child
*
Do you allow the full name of your child to be included in the Prayer of the Faithful (at Mass) the weekend he/she will be baptised
*
Yes
No
Submit
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