St. Thomas a'Becket Baptism Registration Form

First Name of the child being baptized REQUIRED Please fill out this field. Please enter valid data.

Middle Name of the child being baptized REQUIRED Please fill out this field. Please enter valid data.

Last Name of the child being baptized REQUIRED Please fill out this field. Please enter valid data.

Date of Birth REQUIRED Please fill out this field. Please enter a date.

City and State of Birth REQUIRED Please fill out this field. Please enter valid data.

Date of Baptism Please enter a date.

Father's First and Middle Name REQUIRED Please fill out this field. Please enter valid data.

Father's Last Name REQUIRED Please fill out this field. Please enter valid data.

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Are you catholic? REQUIRED Yes No Please fill out this field.

If you are not Catholic, please note your religion Please enter valid data.

Mother's First Name REQUIRED Please fill out this field. Please enter valid data.

Mother's Middle Name REQUIRED Please fill out this field. Please enter valid data.

Mother Last Name REQUIRED Please fill out this field. Please enter valid data.

Mother Maiden Last Name REQUIRED Please fill out this field. Please enter valid data.

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Best Contact Email REQUIRED Please fill out this field. Please enter an email address.

Are you catholic? REQUIRED Yes No Please fill out this field.

If you are not Catholic, please note your religion Please enter valid data.

Address REQUIRED Please fill out this field. Please enter valid data.

City Please enter valid data.

State

Zip Please enter a zip code.

Did you attend a Baptismal Prep Class? Yes No

If you attended a Baptismal Class, what year was it? Please enter valid data.

Are you currently a REGISTERED parishioner at St. Thomas a'Becket? If not, we need a permission letter from your current parish allowing us to baptize your child. Yes No

Full Name of Godfather REQUIRED Please fill out this field. Please enter valid data.

Is Godfather Catholic? (One Godparent needs to be Catholic) REQUIRED Yes No Please fill out this field.

Full Name of Godmother (One Godparent needs to be Catholic) REQUIRED Please fill out this field. Please enter valid data.

Is Godmother Catholic? REQUIRED Yes No Please fill out this field.

*If you have more than one child to baptize, please complete multiple forms. Thank you.

PLEASE REMEMBER TO CLICK THE SUBMIT BUTTON

ST. THOMAS A'BECKET CATHOLIC CHURCH

We WELCOME all, WORSHIP together at the Eucharistic table,
and give WITNESS to Jesus Christ.

Baptism

St. Thomas a'Becket Baptism Registration Form

*If you have more than one child to baptize, please complete multiple forms. Thank you.