Baptism Registration Form

Father's Name REQUIRED Please fill out this field. Please enter valid data.

Mother's First & Maiden Name 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.

Name of Child to be baptized REQUIRED Please fill out this field. Please enter valid data.

Date of Birth REQUIRED Please fill out this field. Please enter valid data.

City of Birth REQUIRED Please fill out this field. Please enter valid data.

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

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

Godparent Information

Both godparents must be at least 16 years of age. At least one godparent must be a practicing and confirmed Catholic. Proof of Confirmation is required, as well as a letter from the godparent's parish stating they are eligible to be a sponsor for baptism. The other godparent must be a Christian and will serve as a Christian Witness to the baptism.

Name of Godfather Please enter valid data.

Is the Godfather Catholic? Yes No

Is Godfather confirmed? Yes No

Name of Godmother Please enter valid data.

Is the Godmother Catholic? Yes No

Is Godmother confirmed? Yes No

Have you attended a Baptism Class in the last 4 years? REQUIRED Yes No If your answer is no, you will need to attend a Baptism Class. Please contact Jeanmarie Sepka at the parish office. Please fill out this field.

If you have any questions, or need to change a response, please contact Jeanmarie Sepka at 410-642-6534 ext. 12, or email [email protected].
Thank you!

Church of the Good Shepherd

Perryville, MD

Baptism Registration Form