Baptism Registration Form

Name of parish where you are registered

Child's first name (if Named)

Child's middle name

Child's last name

Child has been born

Child's Gender

Child's City/State of Birth

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Father's First Name

Father's Last Name

Father's Religion

Father's Email

Mother's First Name

Mother's Maiden Name

Mother's Last Name

Mother's Religion

Mother's Email

Are mother and father married to one another?

Gender Name Name

Godfather's Name

First

Last

Is Godfather Catholic

Godmother's Name

First

Last

Is Godmother Catholic

Have you attended a baptism class? (Okay to attend prior to baby's birth)

When was the baptism class?

Where was the baptism class?

Date requested, concerns, and special circumstances