Baptism Request Form


Registered in this parish?
Home Address
Mailing Address (if different from above)
Marital Status
Primary Phone
Secondary Phone Number


Child's Name


At least one Godparent must be Catholic and have received the Sacrament of Confirmation.
Godfather Name
Is Godfather a confirmed Catholic?

Religious Affiliation

Godmother Name
Is Godmother a confirmed Catholic?

Religious Affiliation - Godmother

GODPARENT PROXY (if applicable)

Will either Godparent be represented by proxy?

Godparent Proxy Name

Name of Proxy


Upcoming 2019 dates are 9/29, 10/27, 11/24, 12/22; 2020 dates are 1/26, 2/9, 3/22, 4/26, 5/31, 6/28. All classes are 1-2 pm. Please fill in which class you plan to attend before the baptism. If you have already attended a class for an older child's baptism, please note in the provided box.

I, as the parent/guardian, acknowledge that this information will be submitted to the parish for use in registration if applicable.