Baptism Register NameThis field is for validation purposes and should be left unchanged.Date of Baptism Month Day Year Mass TimeDate of Workshop Attended Month Day Year Name of Child to be baptized*Date of Birth* Month Day Year City & State of Birth*Father's Name*Religion of Father*Mother's Name (First & Maiden)*Religion of Mother*Address (street/city/state/zip)*Phone (work)Phone (home)*Email* Are you registered in St. Joseph Parish?* Yes No When married/ church/city/state/date*Options for Baptism (check one)* Full Immersion Water on Head only (See blue sheet enclosed)Godfather** Only 1 Catholic Godparent is required and that Godparent needs to be Confirmed, a registered member of a Catholic Parish and receiving Eucharist on a regular basis. **Godfather's NameGodfather's ReligionConfirmed?YesNoCatholic Parish of GodfatherGodmother** Only 1 Catholic Godparent is required and that Godparent needs to be Confirmed, a registered member of a Catholic Parish and receiving Eucharist on a regular basis. **Godmother's NameGodmother's ReligionConfirmed?YesNoCatholic Parish of GodmotherChristian Witness(member of another Christian faith who is not baptized Catholic. No Godparent form is required)Christian Witness NameChristian Witness ReligionProxy, if necessaryProxy's NameWas child adopted?* Yes No Was child privately baptized?* Yes No Baptized by