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  • Full name of child to be baptized REQUIRED Please fill out this field. Please enter valid data.
  • Child's Date of Birth REQUIRED Please fill out this field. Please enter a date.
  • Place of Birth
    • City Please enter valid data.

      State None AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MH MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR PW RI SC SD TN TX UT VA VI VT WA WI WV WY

      Zip Please enter a zip code.
  • Date of Baptism (if previously scheduled) Please enter a date.
  • Mother's Information
    • First Name Please enter valid data.

      Last Name Please enter valid data.
    • Maiden Name Please enter valid data.
    • Baptized? Yes No
    • If Baptized, what was the name of the Church? Please enter valid data.
    • If Baptized, what year? Please enter valid data.
    • Religion Please enter valid data.
    • Received First Communion? Yes No
    • If received First Communion, what year? Please enter an integer (number).
    • Received Confirmation? Yes No
    • If received Confirmation, what year? Please enter valid data.
    • Attended Baptism Class on... (date) Please enter a date.
  • Father's Information
    • First Name Please enter valid data.

      Last Name Please enter valid data.
    • Baptized? Yes No
    • If Baptized, what was the name of the Church? Please enter valid data.
    • If Baptized, what year? Maximum 4 characters Please enter valid data.
    • Religion Please enter valid data.
    • Received First Communion? Yes No
    • If received First Communion, what year? Please enter valid data.
    • Received Confirmation? Yes No
    • If received Confirmation, what year? Please enter valid data.
    • Attended Baptism Class on... (date) Please enter a date.
  • Parents
    • Were you married in the Catholic Church? Yes No
    • If 'Yes', what was the date of your marriage? Please enter a date.
    • Is your family registered at Christ the King Parish? Yes No
    • Mailing Address Line 1 Please enter valid data.
    • City Please enter valid data.

      State None AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MH MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR PW RI SC SD TN TX UT VA VI VT WA WI WV WY

      Zip Please enter a zip code.
    • Phone Number Maximum 20 characters Please enter a phone number.
    • Email (Father) Please enter an email address.
    • Email (Mother) Please enter an email address.
  • Godfather
    • Name Please enter valid data.
    • Attended class on: (date) Please enter a date.
    • In good standing with the Catholic Church and attends weekly mass? Yes No
  • Godmother
    • Name Please enter valid data.
    • Attended class on: (date) Please enter a date.
    • In good standing with the Catholic Church and attends weekly mass? Yes No
  • Additional Comments / Special Circumstances, etc.
  • FOR OFFICE USE ONLY--DO NOT FILL IN
    
    Priest or Deacon's Signature
    _____________________________________________________________________
    
    Date of baptism________________________________________________________
    
    Parents online class____in-person class on _________met W/Monsignor on_______ 
    
    Godparents online class_____ in-person class on ______letter of good standing in ___
    
    
    
    
     

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