Online Registration for Baptism

Complete as much of this registration form as you can at this time. You will be asked to provide any missing information prior to the baptism.

1. Parish Information

At least one parent must be a baptized Catholic who is registered in a Catholic parish.

Please indicate the parish where you are currently registered or plan to register. REQUIRED Blessed Sacrament Queen of Peace Sacred Heart Saint Edward Other Please fill out this field.

If Other, please indicate parish name and location. Please enter valid data.

2. Parents' Information

a. Father's Information:

First Name Please enter valid data.

Last Name Please enter valid data.
Street Address Please enter valid data.
City Please enter valid data.

State

Zip Please enter a zip code.
Phone Number Maximum 20 characters Please enter a phone number.
Email Please enter an email address.
Religion Please enter valid data.
Does the father participate regularly in the spiritual and sacramental life of the Church? Yes No

b. Mother's Information:

First Name Please enter valid data.

Last Name Please enter valid data.
Street Address Please enter valid data.
City Please enter valid data.

State

Zip Please enter a zip code.
Phone Number Maximum 20 characters Please enter a phone number.
Email Please enter an email address.
Religion Please enter valid data.
Does the mother participate regularly in the spiritual and sacramental life of the Church? Yes No

c. Parents' Marital Status:

3. Pre-Baptism Preparation

Have you been excused from attending Pre-Baptism Preparation for this Child? (If "yes", please skip to Certification below) Yes No

Date Attended Please enter a date.

Location Please enter valid data.

Attending Father Mother Other

If "Other", please enter relationship Please enter valid data.

CERTIFICATION: We have read the Baptism Covenant distributed at the Preparation Class and accept the mutual responsibilities of parents and parish for the faith formation of our Child. REQUIRED Yes Yes with Reservations Please fill out this field.

4. Baptism Information

a. Name of Child to be Baptized:

Baptismal Name Please enter valid data.
Middle Name Please enter valid data.
Last Name Please enter valid data.
Date of Birth Please enter a date.

b. Place of Child's Birth:

City Please enter valid data.
State Please enter valid data.
Country Please enter valid data.
Mother's Maiden Name Please enter valid data.
Mother's Date of Baptism (if known) Please enter a date.
Name & Place of Church Where Mother Baptized (if known) Please enter valid data.

c. Date and Place of Baptism for this Child:

Date (if known): Please enter a date.
Church Name: Please enter valid data.
City, State & Country of Church Please enter valid data.
Preferred Mass Time: Please enter valid data.
Please select your preference: During Mass After Mass

d. Birth Parents Information (If different from Section 2, above):

Father's Name: Please enter valid data.
Mother's Name Please enter valid data.

5. Sponsor Information

At least one Baptism Sponsor must be a practicing Catholic who is at least 16 years old and has been Confirmed. A Witness is a baptized and practicing Christian who is not a Catholic.

a. First Sponsor

First Name Please enter valid data.

Last Name Please enter valid data.
Street Address Please enter valid data.
City Please enter valid data.

State

Zip Please enter a zip code.
Sponsor's Religion Please enter valid data.
Is Sponsor Confirmed? Yes No
Does the Sponsor participate regularly in the spiritual and sacramental life of the Church? Yes No

b. Second Sponsor or Witness

First Name Please enter valid data.

Last Name Please enter valid data.
Street Address Please enter valid data.
City Please enter valid data.

State

Zip Please enter a zip code.
Second Sponsor or Witness Religion Please enter valid data.
Is the Second Sponsor or Witness Confirmed? Yes No
Does the Second Sponsor or Witness participate regularly in the spiritual and sacramental life of the Church? Yes No

Thank you for completing your Baptism Registration. If you would like to receive a confirmation email, please provide an email address in the space below: Please enter an email address.

When completed, please click on the "Submit" button.