Baptism Registration Form

Please fill in the fields and click the I'm not a robot box and then submit the form.

Full Legal Name of Child
Address
City, State & Zip Code
Phone
E-Mail
Date of Birth
Place of Birth
Date of Baptism
Father's Full Legal Name
Religion of Father
Mother's Full Legal Name, including Maiden Name
Religion of Mother
Godfather's Full Legal Name
Religion of Godfather
Godmother's Full Legal Name, including Maiden Name
Religion of Godmother
Is either godparent represented by proxy: YesNo
Name of Proxy
Are you registered at St. Mary's: YesNo
: Parents must provide a copy of the "Certificate of Live Birth".
: Also - We do not share this information with others, however, may our pastor or coordinator contact you in the future about religious education and/or Saint Mary’s School information for your child?
OK to contact you?: YesNo
: Please call if you have questions.
: Blessings and thank you!

: OFFICE USE ONLY
Pre-baptismal Preparation with
Date Completed
Date Certificate of Live Birth Provided
Priest / Deacon celebrating Baptism
Date Baptism Certificate Prepared
Date Baptism Recorded in Church Records book
Special Notes:

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