Baptism Registration Form/ Registro de Bautizo

Person to be Baptized/ Persona a ser Bautizada:

First Name/Primer Nombre REQUIRED

Person to be Baptized/ Persona a ser Bautizada:

Please fill out this field. Please enter valid data.

Middle Name/ Nombre del Medio Please enter valid data.

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

Gender/Genero: REQUIRED Male/Masculino Female/ Femenino Please fill out this field.

Date of Birth/ Fecha de Nacimiento REQUIRED Please fill out this field. Please enter valid data.

Place of Birth (City & State)/ Lugar de Nacimiento (Ciudad y Estado): REQUIRED Please fill out this field. Please enter valid data.

Father's Information/ Informacion de Padre:

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

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

Address/ Direccion 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 / Correo Electronico REQUIRED Please fill out this field. Please enter an email address.

Cell Phone Number / Numero Celular REQUIRED Please fill out this field. Please enter a phone number.

Catholic?/ Catolico? REQUIRED Yes/ Si No Please fill out this field.

Parish where you are a Member/ Iglesia de donde es Miembro REQUIRED Please fill out this field. Please enter valid data.

Paticipate in Sacraments/ Participa en Sacramentos REQUIRED Yes/ Si No Please fill out this field.

If you are not Catholic, are you Baptized?/ Si no es Catolico, esta Bautizado? REQUIRED Yes/ Si No Please fill out this field.

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

Are you married in the Catholic Church?/ Esta casado por la Iglesia Catolica? REQUIRED Yes/ Si No Please fill out this field.

If no, by a minister?/ Si no, por un ministro? REQUIRED Yes/ Si No Please fill out this field.

Do you intend to raise and educate your child in the Catholic faith?/ Intena criar y educar a sus hijos en la fe Catolica? REQUIRED Yes/ Si No Please fill out this field.

Mother's Information/ Informacion de Madre:

First 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/ Apellido de Soltera REQUIRED Please fill out this field. Please enter valid data.

Address/ Direccion 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 / Correo Electornico REQUIRED Please fill out this field. Please enter an email address.

Cell Phone Number / Numero Cellar REQUIRED Please fill out this field. Please enter a phone number.