Baptism Registration Form

Full name of child to be baptized REQUIRED Please fill out this field. Please enter valid data.

Child's Date of Birth REQUIRED Please fill out this field. Please enter a date.

Date Attending Baptism Class REQUIRED Please fill out this field. Please enter valid data.

Names of Parents Attending Baptism Class REQUIRED Please fill out this field. Please enter valid data.

Names of Godparents Attending Baptism Class REQUIRED Please fill out this field. Please enter valid data.

Place of Birth

City Please enter valid data.

State

Zip Please enter a zip code.

Date of Baptism (if previously scheduled) Please enter a date.

Mother's Information

First Name Please enter valid data.

Last Name Please enter valid data.
Maiden Name REQUIRED Please fill out this field. Please enter valid data.
Baptized? Yes No
If Baptized, what was the name of the Church? Please enter valid data.
If Baptized, what year? Please enter valid data.
Religion Please enter valid data.
Received First Communion? Yes No
If received First Communion, what year? Please enter an integer (number).
Received Confirmation? Yes No
If received Confirmation, what year? Please enter valid data.
Attended Baptism Class on... (date) Please enter a date.

Father's Information

First Name Please enter valid data.

Last Name Please enter valid data.
Baptized? Yes No
If Baptized, what was the name of the Church? Please enter valid data.
If Baptized, what year? Maximum 4 characters Please enter valid data.
Religion Please enter valid data.
Received First Communion? Yes No
If received First Communion, what year? Please enter valid data.
Received Confirmation? Yes No
If received Confirmation, what year? Please enter valid data.
Attended Baptism Class on... (date) Please enter a date.

Parents

Were you married in the Catholic Church? Yes No
If 'Yes', what was the date of your marriage? Please enter a date.
Were either of you previously married? Yes No
Is your family registered at Christ the King Parish? Yes No
Mailing Address Line 1 Please enter valid data.
City Please enter valid data.

State

Zip Please enter a zip code.
Phone Number

Please enter a phone number.
Email (Father) REQUIRED Please fill out this field. Please enter an email address.
Email (Mother) REQUIRED Please fill out this field. Please enter an email address.

Godfather

Name Please enter valid data.
Attended class on: (date) Please enter a date.
In good standing with the Catholic Church and attends weekly mass? Yes No

Godmother

Name Please enter valid data.
Attended class on: (date) Please enter a date.
In good standing with the Catholic Church and attends weekly mass? Yes No

Additional Comments / Special Circumstances, etc.

FOR OFFICE USE ONLY--DO NOT FILL IN

Priest or Deacon's Signature
_____________________________________________________________________

Date of baptism________________________________________________________

Parents online class____in-person class on _________met W/Monsignor on_______

Godparents online class_____ in-person class on ______letter of good standing in ___