Baptismal Registration Form

Today's Date REQUIRED Please fill out this field. Please enter a date.

A. Father's Information

Father's First Name REQUIRED Please fill out this field. Please enter valid data.
Father's Middle Name (Put "X" or "None" if you do not have one) REQUIRED Please fill out this field. Please enter valid data.
Father's Last Name REQUIRED Please fill out this field. Please enter valid data.
Father's Religion REQUIRED Please fill out this field.
Father's Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
Father's Email Please enter an email address.

B. Mother's Information

Mother's First Name REQUIRED Please fill out this field. Please enter valid data.
Mother's Middle Name (Put "X" or "None" if you do not have one) Please enter valid data.
Mother's Religion REQUIRED Please fill out this field.
Mother's Maiden Name Please enter valid data.
Mother's Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
Mother's Email Please enter an email address.

Family Mailing 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.

Are you a "registered" member of Our Lady of Victory Catholic Church? REQUIRED Yes No Please fill out this field.

If not, which parish do you belong? Please enter valid data.

C. Current Marital Status

Were you married in the Catholic Church by a Catholic Priest or Catholic Deacon? REQUIRED Yes No Please fill out this field.
If not, were you married in a church, civilly, or by common law? REQUIRED Yes No Please fill out this field.

D. Child to be Baptized

Child's First Name REQUIRED Please fill out this field. Please enter valid data.
Child's Middle Name (Put "X" or "None" if you do not have one) Please enter valid data.
Child's Last Name REQUIRED Please fill out this field. Please enter valid data.

E. Child's Place & Date of Birth

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.
Child's Date of Birth REQUIRED Please fill out this field. Please enter a date.
1. Was your child adopted? REQUIRED Yes No Please fill out this field.
2. Was your child baptized in an emergency? REQUIRED Yes No Please fill out this field.
If yes, Child's Date of Emergency Baptism: Please enter a date.
3. Place of Emergency Baptism: Please enter valid data.
City Please enter valid data.

State

Zip Please enter a zip code.

One Godparent is required for Baptism. You may have two Godparents, one Godfather and one Godmother.
Once you receive a confirmation email from the church, you will be instructed to send a Godparent Registration Form link to prospective godparents. They are to fill out their form and submitted to the church. You and your Godparents will receive an email from Deacon Dan Dailey regarding Baptismal preparation sessions.

H. Preferred Date for the Baptism REQUIRED Please fill out this field. Please enter a date.

I. Preferred Time for the Baptism REQUIRED During the 4:00 PM Saturday Vigil Mass After the 4:00 PM Saturday Vigil Mass During the 11:00 AM Sunday Mass After the 11:00 AM Sunday Mass Please fill out this field.

J. Preferred Clergy to Confer the Sacrament of Baptism REQUIRED Father Roy C. Marien, Pastor Deacon Dan Dailey Please fill out this field.