Baptismal Registration Form

Baptismal Registration Form
Scheduled Baptismal Date

MonthDayYear
Name of Child*
First / Middle / Last
Birth Date*

MonthDayYear
Place of Birth*
City of Birth*
State of Birth*
Mother's Name*

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

First NameLast Name
Father's Religion*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
E-mail*
example@example.com
Are parents married?*
If yes, were parents married by a Catholic priest or deacon?*
Godfather Name*
Is Godfather a Catholic?*
Godmother Name*
Is Godmother a Catholic?*
Is either Godparent represented by a Proxy?*
If yes, name of Proxy
Was the child privately baptized?*
Enter the message as it's shown*
Should be Empty: