Baptism Registration Form
Name of Parish:
City:
Child's Name:
First Name
Last Name
Date of Birth:
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Birth Place:
Mother's Name:
First Name
Last Name
Mother's Religion:
Father's Name:
First Name
Last Name
Father's Religion:
Are both parents having full custody of the child?
Yes
No
Are parents married?
Yes
No
Family Contact Information
Phone Number:
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address:
example@example.com
Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Godparent Information
Godfather's Name:
First Name
Last Name
Godfather's Religion:
Godmother's Name:
First Name
Last Name
Godmother's Religion:
Is either Godparent represented by proxy?
Yes
No
Was the child baptized before?
Yes
No
Was the child adopted?
Yes
No
Date & Time of Baptism:
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Date:
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Parent Signature:
Submit
Should be Empty: