St. Edward Catholic Church
Assumption of the Blessed Virgin

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Baptism Form

- Sacraments/Register

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- Name of Child Please enter valid data.
- Date of Birth Please enter valid data.
- Place of Birth 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.
- Requested Date of Baptism Please enter valid data.
- Email REQUIRED Please fill out this field. Please enter an email address.
- 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.
- Father's Name Please enter valid data.
- Father's Religion Please enter valid data.
- Mother's Maiden Name Please enter valid data.
- Mother's Religion Please enter valid data.
- Were Parents Married by a Catholic Priest? Please enter valid data.
- Godfather Please enter valid data.
- Is Godfather a Catholic? Please enter valid data.
- Godmother Please enter valid data.
- Is Godmother a Catholic? Please enter valid data.
- Name of Proxy Please enter valid data.
- Is either Godparent represented by a Proxy Please enter valid data.
- Was the child privately baptized privately? Please enter valid data.
- Was the child adopted? Please enter valid data.
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