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 Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming 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...