Baptism Register

Full Name of Child

Residence                                      

Telephone Number	

Date of Birth	Sex of Child:________

Place of Birth	

Date of Baptism	

Father’s Full Name                                  

Religion of Father                                

Mother’s Full Maiden Name                             

Religion of Mother	

Were Parents Married by a Catholic Priest?	

Godfather                                      

Is Godfather a Catholic?                            

Godmother	

Is Godmother a Catholic?	

Is either Godparent represented by Proxy?	

Name of Proxy	

Was the child privately baptized?                        

Was the child adopted?	
Date of final Decree:_________________ Court where decree issued:_________________
Date of Baptismal Preparation Class	Date of Reg. in Parish

Name of Priest /Deacon