Baptism Registration Form

Family Information

Date

//

Child's Name

First Name

Middle Name

Last Name

Child's Date of Birth

//

Place of Birth (City & State)

Father's Name

First Name

Last Name

Father's Religion

Mother (Maiden Name)

First Name

Last Name

Mother's Religion

Address

Home Phone

--

Daytime Phone

--

Name of First Sponsor (or Christian Witness)

Religion of First Sponsor

Name of Second Sponsor (or Christian Witness)

Religion of Second Sponsor

Is your family registered at Holy Rosary Parish

	Yes
	No

How often does your family attend Mass

Where were you married

Date of your marriage

//

Is this your first child

	Yes
	No

Have you ever attended a Pre-Baptism Program

	Yes
	No

If yes, where and when

For Office Use ONLY

Priest/Deacon:

First Name

Last Name

Type of Baptism program required

	NONE: (already attended program)
	BASIC (requires one session)
	FULL (needs extended preparation)

For BASIC, date attended

//

Date of Baptism

//

Time of Baptism

:

Presider

First Name

Last Name

Recorded in Sacramental Book

	Yes
	No

Recorded in PDS

	Yes
	No