Submit Baptism Registration Information

Child's Information

First Name REQUIRED Please fill out this field. Please enter valid data.
Middle Name REQUIRED Please fill out this field. Please enter valid data.
Last Name REQUIRED Please fill out this field. Please enter valid data.
Date of Birth REQUIRED Please fill out this field. Please enter valid data.
Town of Birth REQUIRED Please fill out this field. Please enter valid data.

Family Information

Street 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.
Email REQUIRED Please fill out this field. Please enter an email address.
Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
Parish Registered In REQUIRED St. Mary, Manchester St. Patrick, Ryan Immaculate Conception, Masonville St. John, Delhi Other (Please specify) Please fill out this field.
Other Parish Please enter valid data.

Father's Information

First Name REQUIRED Please fill out this field. Please enter valid data.
Middle Name REQUIRED Please fill out this field. Please enter valid data.
Last Name REQUIRED Please fill out this field. Please enter valid data.
Religion REQUIRED Please fill out this field. Please enter valid data.

Mother's Information

First Name REQUIRED Please fill out this field. Please enter valid data.
Middle Name REQUIRED Please fill out this field. Please enter valid data.
Last Name REQUIRED Please fill out this field. Please enter valid data.
Maiden Name REQUIRED Please fill out this field. Please enter valid data.
Religion REQUIRED Please fill out this field. Please enter valid data.

Are the child's parents married? REQUIRED Yes No Please fill out this field.

If so, were they married in the Catholic Church? REQUIRED Yes No Please fill out this field.

Godfather's Information

First Name REQUIRED Please fill out this field. Please enter valid data.
Middle Name REQUIRED Please fill out this field. Please enter valid data.
Last Name REQUIRED Please fill out this field. Please enter valid data.
Is the Godfather a confirmed and practicing Catholic? REQUIRED Yes No Please fill out this field.

Godmother's Information

First Name REQUIRED Please fill out this field. Please enter valid data.
Middle Name REQUIRED Please fill out this field. Please enter valid data.
Last Name REQUIRED Please fill out this field. Please enter valid data.
Is the Godmother a confirmed and practicing Catholic? REQUIRED Yes No Please fill out this field.

Is either Godparent represented by proxy? REQUIRED Yes No Please fill out this field.

Name of Proxy Please enter valid data.

Date of Baptism Class Attended or Registered For REQUIRED Please fill out this field. Please enter valid data.

Ceremonial Details

Location of Baptism REQUIRED St. Mary, Manchester St. Patrick, Ryan Immaculate Conception, Masonville St. John, Delhi Please fill out this field.
Date of Baptism REQUIRED Please fill out this field. Please enter valid data.
Timing of Sacrament REQUIRED During Mass After Mass Please fill out this field.
Name of Priest/Deacon REQUIRED Please fill out this field. Please enter valid data.
Number of Pews to Reserve Please enter valid data.

The recommended contribution is $20 which can be dropped off at the Cluster office or in the offertory marked as "Baptism - Name". Please select this field.