Baptism Registration Form

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  - Baptism Registration Form

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- Child'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.
- Middle Name Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Place of Birth (City, State) 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 Please fill out this field. Please enter a phone number.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Date of Baptism REQUIRED Please fill out this field. Please enter valid data.
- Father's Name REQUIRED Please fill out this field. Please enter valid data.
- Father's Religion REQUIRED Please fill out this field. Please enter valid data.
- Mother's First and Maiden Name REQUIRED Please fill out this field. Please enter valid data.
- Mother's Religion REQUIRED Please fill out this field. Please enter valid data.
- Were you married by a Catholic priest? Yes No
- Godfather's Name REQUIRED Please fill out this field. Please enter valid data.
- Is the Godfather Catholic? REQUIRED Please fill out this field. Please enter valid data.
- Godmother's Name REQUIRED Please fill out this field. Please enter valid data.
- Is the Godmother Catholic? REQUIRED Please fill out this field. Please enter valid data.
- Priest REQUIRED Please fill out this field. Please enter valid data.
- Was the child privately baptized? REQUIRED Please fill out this field. Please enter valid data.
- Memoranda Please enter valid data.
Submit

Epiphany Catholic
Church

Washington, DC

Baptism Registration Form