Baptism Registration Form

Child

Child's Full Name REQUIRED Please fill out this field. Please enter valid data.
Date of Birth REQUIRED Please fill out this field. Please enter valid data.
City and State of Birth REQUIRED Please fill out this field. Please enter valid data.

Child's Mother

Mother's Maiden Name (First & Last - Maiden) REQUIRED Please fill out this field. Please enter valid data.
Email REQUIRED Please fill out this field. Please enter valid data.
Phone Number REQUIRED Please fill out this field. Please enter valid data.
Religion REQUIRED Please fill out this field. Please enter valid data.
Parish Registration REQUIRED Please fill out this field. Please enter valid data.

Child's Father

Father's Name (First & Last) REQUIRED Please fill out this field. Please enter valid data.
Email REQUIRED Please fill out this field. Please enter valid data.
Phone Number REQUIRED Please fill out this field. Please enter valid data.
Religion REQUIRED Please fill out this field. Please enter valid data.
Parish Registration REQUIRED Please fill out this field. Please enter valid data.

Family Address

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.

Sponsor's Names

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

Baptism Preparation Sessions are offered on Saturdays from 10:00- 11:00 am four times per year. Upcoming Baptism Preparation Sessions: Please choose a date: REQUIRED Saturday, May 2, 2026 (10:00 am) Saturday, August 15, 2026 (10:00 am Saturday, November 7, 2026 (10:00 am) Saturday, February 27, 2027 (10:00 am) Saturday, May 1, 2027 (10:00 am) Saturday, August 14, 2027 (10:00 am) Saturday, November 6, 2027 (10:00 am) Already attended a class in the last five years Please fill out this field.

I give permission for my child to be prayed for by name at during the intercessions at the weekend Masses on the weekend of the baptism and also listed in the bulletin REQUIRED Yes No Please fill out this field.

I give permission for photographs from the baptism to be posted on Our Lady of Lourdes' social media platforms REQUIRED Yes No Please fill out this field.