Baptism Registration Form

Child Information

Name of Child*

First Middle Name Last Suffix

Please include full name.

Sex of Child*

Female
Male

Date of Birth*

Place of Birth*

enter city & state

Previously Baptized?*

Yes
No

Place of Previous Baptism*

Mother

Name*

First Maiden Last

Marital Status*

Single
Married
Divorced
Widowed

Religion*

Address*

Street Address Address Line 2 City State ZIP Code

Phone*

Email*

Father

Name*

First Last

Marital Status*

Single
Married
Divorced
Widowed

Religion*

Address*

Street Address Address Line 2 City State ZIP Code

Phone*

Email*

Godparents

(Must be Catholic. need a letter from their parish stating they are practicing and in good standing)

Godfather's name*

First Last

Godfather in Good Standing*

Yes
No

Name of Parish Registered*

Parish Registration Address*

Street Address Address Line 2 City State ZIP Code

Letter for Godfather in Good Standing

Accepted file types: jpg, pdf, doc, docx, png, gif, Max. file size: 15 MB.

Godmother's name*

First Last

Godmother in Good Standing*

Yes
No

Name of Parish Registered*

Parish Registration Address*

Street Address Address Line 2 City State ZIP Code

Letter for Godmother in Good Standing

Accepted file types: jpg, pdf, doc, docx, png, gif, Max. file size: 15 MB.

Christian Witness

optional if only one godparent and must be opposite gender, but they need to initiate the request

Name of Christian Witness

First Last

Religious Denomination

Other Parent Information

Parish of Parent Registration Name & Place*

Parish Registration Address*

Street Address Address Line 2 City State ZIP Code

Phone Number of Parish*

Marital Validity*

Last Attendance of Baptism Prep Program*

Enter Year & Place

Request for particular priest/deacon

Add contact info if not from our parish

Requested Date*

Requested Time*

:

Additional Information

Other Comments

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Phone

This field is for validation purposes and should be left unchanged.