Baptism Registration Form

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Address REQUIRED Please fill out this field. Please enter valid data.

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

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

City of Birth REQUIRED Please fill out this field. Please enter valid data.

Father's Name REQUIRED Please fill out this field. Please enter valid data.

Father's Religion REQUIRED Please fill out this field. Please enter valid data.

If Catholic, Practicing? REQUIRED Yes No Please fill out this field.

Mother (Maiden Name REQUIRED Please fill out this field. Please enter valid data.

Mother's Religion REQUIRED Please fill out this field. Please enter valid data.

If Catholic, Practicing? REQUIRED Yes No Please fill out this field.

Married in Church? REQUIRED Yes No Please fill out this field.

If yes, where? Please enter valid data.

Are Parents Registered? REQUIRED Yes No Please fill out this field.

If yes, what is your Env #? Please enter valid data.

Legal Gaurdian(s) Please enter valid data.

Documentation Please enter valid data.

If Catholic, practicing? Yes No

Godfather's Name REQUIRED Please fill out this field. Please enter valid data.

Godfather's Religion REQUIRED Please fill out this field. Please enter valid data.

Out of Parish Letter Yes

Godmother's Name REQUIRED Please fill out this field. Please enter valid data.

Godmother's Religion REQUIRED Please fill out this field. Please enter valid data.

Out of Parish Letter Yes

Most Pure Heart of Mary Church