Baptism Registration Form
Child's Name:
*
First Middle
Last
Date of Birth:
*
-
Month
-
Day
Year
Date
Birth Place:
*
City, Province, Country
Gender of Child
*
Male
Female
Is this your first child to be Baptized?
*
Yes
No
Mother's Name:
*
First Name
Last Name
Mother's Religion:
Mother Baptized
*
Yes
No
Father's Name:
*
First Name
Last Name
Father's Religion:
Father Baptized
*
Yes
No
Do both parents reside with this child?
*
Yes
No
Family Contact Information
Marriage of Parents
*
Catholic Church
Civil
Not married
Other
Main Contact Name
*
Main Contact Phone Number:
*
Please enter a valid phone number.
Main Contact Email Address:
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Godparent Information
Godparents are to be confirmed Catholics in good standing with the Church. A child can be baptized with either one godparent or a godmother and a godfather. NOTE: You will need to submit a copy of the godparent(s) Confirmation certificate to the parish office
Godfather's Name:
First Name
Last Name
Godfather's Religion:
Godmother's Name:
First Name
Last Name
Godmother's Religion:
Will either Godparent be represented by proxy?
Yes
No
Was the child Baptized before?
*
Yes
No
For Office Use:
Birth Certificate Received
Yes
Godparent Confirmation certificate received
Yes
Date of Baptism preparation class
Date of Baptism
Officiating Priest
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Submit
Should be Empty: