Proposed Date of Baptism

Father will confirm this with you. If you don't know, just leave this blank.

MM

DD

YYYY

Clergy

Fr Ryan

Another Priest or Deacon from outside the Parish

Contact Phone *

How can we follow up with you via phone?

(###)

###

####

Can we text you? *

Yes

No

Child's Date of Birth *

MM

DD

YYYY

Father's Date of Birth *

MM

DD

YYYY

Mother's Date of Birth *

MM

DD

YYYY

Do any of these apply?

Child is adopted

Child is being raised (legally) by grandparents/relatives/other guardian

Child is formally a ward of the state

Child has a diminished mental capacity