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Baptism Registration

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  Child Information
  
  Today's Date REQUIRED Please fill out this field. Please enter a date.
  
  Child's First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Middle Name Please enter valid data.
  
  Child's Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Birthdate REQUIRED Please fill out this field. Please enter a date.
  
  Child's Birth City and State REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Gender Male Female
  
  Select your 1st and 2nd choice of dates from the schedule above. Although we try, we cannot guarantee your first choice. You will receive an email confirming the actual date of your child's baptism within 3 business days.
  
  Baptism Date - First Choice REQUIRED Please fill out this field.
  
  Baptism Date - Second Choice REQUIRED Please fill out this field.
  
  Parent Information
  
  Parent #1 - First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Parent #1 - Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Parent #1 - Last Name (as it appears on birth certificate) REQUIRED Please fill out this field. Please enter valid data.
  
  Parent #1 - Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Parent #2 - First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Parent #2 - Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Parent #2 - Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Parent #2 - Former Name (as it appears on birth certificate) REQUIRED Please fill out this field. Please enter valid data.
  
  Former Names: St. Monica realises this information may be of a sensitive nature, but is a canonical requirement for recording the sacrament. Please provide names as reflected on the birth/baptism certificate of the parents and godparents.
  
  Parent #2 - Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Address REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Is this your first child to be baptized? REQUIRED Yes No Please fill out this field.
  
  Were the parents married in the Catholic Church? REQUIRED Yes No Please fill out this field.
  
  Is the family registered at St. Monica Church? REQUIRED Yes No Please fill out this field.
  
  Godparent Information
  
  Godparent Information Godparent(s) must be at least 16 years old, a confirmed Catholic, practicing their faith, and be willing to accept the responsibility of supporting their godchild in faith.
  
  Godfather's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Godfather's Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Godmother's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Godmother's Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Proxy's Name (if any) and Religion Please enter valid data.
  
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