Baptism Scheduling Form

Information on child to be baptised:

Child's FULL Name (First Middle Last) REQUIRED Please fill out this field. Please enter valid data.

Child's Gender REQUIRED Female Male Please fill out this field.

Child's Date of Birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter a date.

Child's City, State of Birth REQUIRED Please fill out this field. Please enter valid data.

Is this your first child to be baptized? REQUIRED Please fill out this field.

Have you previously attended a Baptism Prep class? REQUIRED Yes No Please fill out this field.

If yes, enter approx date and where taken REQUIRED Please fill out this field. Please enter valid data.

Family Contact Information:

Your Street 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.

I wish to register my family as members of: REQUIRED Christ the King Parish (St. Agnes & St. Athanasius Churches) We are already members of Christ the King Parish (St. Agnes & St. Athanasius Churches) I am registered at another parish (please enter Home Parish name and city below) Not at this time Please fill out this field.

Your Home Parish's Name and City Please enter valid data.

Comments

Mother's FULL Name ( First Middle Last) REQUIRED Please fill out this field. Please enter valid data.

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

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

Father's FULL Name (First Middle Last) REQUIRED Please fill out this field. Please enter valid data.

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

Are you married? REQUIRED Yes No Please fill out this field.

Were you married in the Catholic Church? REQUIRED Yes No Please fill out this field.

If married in the Catholic Church enter Church name and City: REQUIRED Please fill out this field. Please enter valid data.

Godmother's FULL Name (First Middle Last) REQUIRED Please fill out this field. Please enter valid data.

Godmother's Religion REQUIRED Please fill out this field. Please enter valid data.

Godfather's FULL Name (First Middle Last) REQUIRED Please fill out this field. Please enter valid data.

Godfather's Religion REQUIRED Please fill out this field. Please enter valid data.

Any additional Information you wish us to know?

*** If this is your first child to be baptized, parents are required to attend the Parent Baptism Meeting. Parent Meetings are held on the First Friday of every month at the St. Athanasius Parish Center, 300 Haverhill Street, Reading