Baptism Registration Form Baptism Registration Form Child(ren) to be Baptized – please use ADD button for multiple Child’s Full Name * Child's Full Name Child's Full Name Child's Full Name Child's Full Name Date of Birth * Gender * Male Female Place of Birth * Add Remove Home Address * Home Address Home Address Home Address Home Address Home Address State AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Home Address Cell Phone Number * Email address * Was the child baptized privately in a hospital or elsewhere? * YES NO Birth Father’s Name * Birth Father's Name Birth Father's Name Birth Father's Name Birth Father's Name Father’s Religion * Birth Mother’s Name * Birth Mother's Name Birth Mother's Name Birth Mother's Name Birth Mother's Name Mother’s Maiden Name * Mother’s Religion * Married * YES NO Have you previously filled out a Registration Form to be a parishioner of St. Clare of Assisi Parish? * YES NO Church Attendance * Regular Occasionally Seldom Sponsors – (2) please use ADD button to input 2nd sponsor information Sponsor’s Full Name * Sponsor's Full Name Sponsor's Full Name Sponsor's Full Name Age * Religion * Parish Church – please list full name, city & state * Received Confirmation? * YES NO I understand Sponsors will need to obtain a letter of eligibility from their home Parish. * YES Add Remove Siblings – please use ADD button to input additional children Child’s Name Child's Name Child's Name Child's Name Age Add Remove Suggested Baptism Donation * Parish Office Use Only Day/Date of Baptism Time of Baptism Location Presider Copy to Priest/Deacon to contact/follow up Family Registered; ID# Sponsors Eligibility Rc’d Baptismal Cert prepared If you are human, leave this field blank. Submit Δ Share this:TwitterFacebookLike this:Like Loading...