Baptism Registration Form

Baptism Information

Your Child

First Name REQUIRED Please fill out this field. Please enter valid data.
Middle Name Please enter valid data.
Last Name REQUIRED Please fill out this field. Please enter valid data.
Boy or Girl REQUIRED Boy Girl Please fill out this field.
Is this your first child to be baptized at Sacred Heart Parish? REQUIRED Yes No Please fill out this field.
Date of birth REQUIRED Please fill out this field. Please enter valid data.
Place of birth (city and state/country) REQUIRED Please fill out this field. Please enter valid data.

Father

Mother

First Name REQUIRED Please fill out this field. Please enter valid data.
Middle Name Please enter valid data.
MAIDEN Name (before marriage) REQUIRED
The mother's last name at birth, before she was married (maiden name)
Please fill out this field. Please enter valid data.
Religion REQUIRED Please fill out this field.

Are you married in the Catholic Church? REQUIRED Yes No Please fill out this field.

Contact information

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

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.
Email Address REQUIRED Please fill out this field. Please enter an email address.
Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
Alternate Phone Number Maximum 20 characters Please enter a phone number.

Requirements to Serve as a Godparent:

Have received all of the Sacraments of Initation (Baptism, Eucharist, and Confirmation) in the Catholic faith
At least 16 years of age
Free to serve as a Godparent without impediment
Are practicing in their faith
Not the parent of the child to be baptized

Godfather

Godmother

General Information

Would you prefer the baptism liturgy to be: REQUIRED During Mass (English) Durante la Misa (en español) Group Baptism (English) Bautismo comunitario (en español) Please fill out this field.

Additional Information