Baptism Registration Form
Immaculate Conception Parish Registration for Baptism
Name of child to be baptized
Last Name
Your answer
First Name
Your answer
Middle Name
Your answer
Place of Birth (City and State)
Your answer
Date of Birth (MM/DD/YYYY)
Your answer
Date of Baptism (MM/DD/YYYY)
Your answer
Parent Information
Father's Name (First and Last)
Your answer
Mother's Name (First, Last and Maiden)
Your answer
Father's Religion
Your answer
Mother's Religion
Your answer
Were the parents married by a Catholic Priest or Deacon?
Are parents registered members of Immaculate Conception Parish?
Godparent Information
Note: At least one Godparent is required. A Godparent must be 16 years old, baptized & confirmed in the Catholic Church, and actively practicing the Catholic faith.
Godfather's Name (First and Last)
Your answer
Is the Godfather Catholic?
Godmother's Name (First and Last)
Your answer
Is the Godmother Catholic?
Okay to publish notice of Baptism in the parish bulletin?
Parents' Address
Your answer
City
Your answer
State
Your answer
Zip
Your answer
Phone Number
Your answer
Email
Your answer
Submit
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