Baptism Class Registration

Class in Spanish or English: *

Choose a Class: *

Mother's First Name *

Mother's Last Name *

Mother's Date of Birth * +

Mother's Phone Number *

Father's First Name *

Father's Last Name *

Father's Date of Birth * +

Father's Phone Number *

Is the Child Born: *

First Name of Child to be Baptized (put unknow if no name is yet chosen) *

Last Name of Child to be Baptized *

Child's Birthday: * +

What parish do you belong to: *

Best email to contact you: *

Re-enter email address: *

Street Address *

City *

State *

Zip Code *

Is this your first child to be baptized: *

Yes

No

Are parents married? *

Yes

No

Were you married in the church? *

Yes

No

Are you living at the same address? *

Yes

No

Do you have a date set to get married? *

Yes

No

Comments or questions: