Baptism Registration Form

Note - This form can also be filled out in person at the Church office.

Date of Baptism *

Time: *

Place (Church): *

Child's Information

Child's Last Name: *

Child's First Name: *

Child's Middle Name(s):

Date of Birth: *

Age: *

Months:

Was the Child Baptized in an Emergency?

Yes

If yes please explain:

Parent's Information

If parents are divorced or separated, extra form needed.

Are the parents together? *

Yes

No

If together, were they married in the church? *

Yes

No

Father's Information

Father's Last Name: *

Father's First Name: *

Father's Middle Name(s):

Father's Telephone Number:

Father is Catholic? *

Yes

No

Father's Email *

Father's Home Address *

Mother's Information

Mother's Last Name: *

Mother's First Name: *

Mother's Middle Name(s):

Mother's Telephone Number:

Mother is Catholic? *

Yes

No

Mother's Email *

Mother's Home Address *

Sponsor's Information

One set of godparents or one of each is permitted

Godfather's Name

Godfather's Telephone #

Catholic

Yes

No

Godmother's Name

Godmother's Telephone #

Catholic

Yes

No

To complete registration, besides this form, you must also turn in the following (2 weeks prior baptism):

Child's birth certificate
Proof baptismal class (parents & sponsors)
Letter of candidacy
$50 Process fee

Signature of Mother or Father: *

Choose File

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