Baptism Registration Form

Name of Child*

First Middle Last

Residence*

Street Address Address Line 2 City State ZIP Code

Phone Number*

Date of Birth*

Place of Birth*

Main Contact Email*

Date of Baptism*

Father's Name*

First Last

Religion of Father*

Mother's Name*

First Maiden Last

Religion of Mother*

In What Church were Parents Married?

Godfather's Name*

First Last

Is the Godfather Catholic?*

Godmother's Name*

First Last

Is the Godmother Catholic?*

Is either Godparent represented by Proxy?*

Was the Child Privately Baptized?*

Was the Child Adopted?*

Remarks

Name of Priest/Deacon*

First Last

CAPTCHA

Name

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