Baptism Certificate Information

Please provide the information below to be filled into your child’s Baptism Certificate

"*" indicates required fields

Child's Full Name*

Date of Birth*

Baptism Date*

Child's City of Birth*

Primary Phone Contact*

Primary Email Contact*

Address*

Street Address Address Line 2 City State ZIP Code

Father's Name

First Last

Mother's First and Maiden Name

First Last

Godfather's Name

First Last

Godmother's Name

First Last

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