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Baptism Registration Form

Please contact the office at 203-333-7575 before submitting this form.
Thank you.
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  Child Information
  
  First 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.
  
  Place of birth - (City/Town & State) REQUIRED Please fill out this field. Please enter valid data.
  
  Father's Information
  
  First 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.
  
  Church attending (Name of church, City/Town & State) Please enter valid data.
  
  Mother's Name (First, Last, and Maiden) REQUIRED Please fill out this field. Please enter valid data.
  
  Religion Please enter valid data.
  
  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.
  
  Family mailing address
  
  Address 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.
  
  Married by: (name of priest or minister) Please enter valid data.
  
  Name of church or place of marriage: Please enter valid data.
  
  Church currently attending (Name of church, City/Town & State) Please enter valid data.
  
  Godparent Information
  
  Godparents must provide: (1) sacrament certificates of baptism, 1st Communion, and Confiramtion (2) be at least 16 years old confirmed as a Catholic; and (3) if married - have a vaild Catholic marriage (be married within the Church)
  
  Godfather Information
  
  First 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 presently a Catholic who has been confirmed? REQUIRED Yes No Please fill out this field.
  
  Godmother Information
  
  First 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 presently a Catholic who have been confirmed? REQUIRED Yes No Please fill out this field.
  
  Christian Witness (in leiu of one Godparent)
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Is the Christian Witness a baptized Christian? Yes No
  
  For Office use only:
  
  Priest: __________________________________________________________
  
  Date of Baptism:____________________ Time of Baptism: __________
  
  Baptism class completed on: ____________________________________
  
  Submit
  
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Our Lady of Fatima

Bridgeport, CT

Baptism Registration Form

Please contact the office at 203-333-7575 before submitting this form.
Thank you.