Baptism Registration Form

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Please note a parent MUST complete the following information.

Requested Baptism Date

January 25

February 8

April 26

May 3

May 31

Baptism during a Mass (will be contacted to schedule)

Have you attended a Baptism Class?

Yes

No

If so, please list date and where class was completed

Child's Full Name

Date of Birth

Place of Birth

Gender

Male

Female

Was the Child Adopted?

Yes

No

Adoption Date

Was Child already Baptized Privately?

Yes

No

If so, by whom?

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PARENTS

Please use full legal names. The information required on this form will be transferred to the permanent parish record of your child's baptism.

Father's Full Name

Father's Religion

Father's Email

Father's Mobile Number

Father's Consent

Yes

No

Mother's Full Name (include Maiden Name)

Mother's Religion

Mother's Email

Mother's Mobile Number

Mother's Consent

Yes

No

Street Address

City/State/Zip Code

Date of Marriage

Church/Place of Marriage (include City and State)

Do You have other Children?

Yes

No

If yes, please list names and ages

Are You Registered at HNJ?

Yes

No

If not, what parish are you registered at?

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GODPARENTS

At least one godparent must be confirmed, practicing Catholic over age of 16 and must submit a sponsor certificate.

Godfather or Christian Witness Full Name

Godfather's Name of Parish (include City and State)

Godmother or Christian Witness Full Name

If yes, please include full name of proxy

Godmother's Name of Parish (include City and State)

Is either represented by a proxy?

Yes

No

Any specific requests/concerns/comments?

Baptism Registration Form

Baptismal Request

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