Baptism Registration Form

Child's Information

First Name of Child

Middle Name of Child

Last Name of Child

Address

Address Line 1

Address Line 2

City

State

Zip Code

Date of Birth

Place of Birth

Requested Date of Baptism

Was the child ever privately baptized?

Yes

Father's Information

First Name of Father

Middle Name of Father

Last Name of Father

Religion of Father

Father's Place of Birth

Mother's Information

First Name of Mother

Middle Name of Mother

Maiden Last Name of Mother

Religion of Mother

Mother's Place of Birth

Godparents' Information

First Name of Godfather

Middle Name of Godfather

Last Name of Godfather

Is Godfather a Catholic?

Yes

First Name of Godmother

Middle Name of Godmother

Last Name of Godmother

Is Godmother a Catholic?

Yes

Catholic Clergy Who Performed Our Marriage

Were the Parents Married by a Catholic Clergy

Yes

Title of Catholic Clergy

First Name of Catholic Clergy

Last Name of Catholic Clergy

Parish where Married

City of Parish where Married

State of Parish where Married

Contact Information

Home Phone

Mobile Phone

Additional Information

Church Notes