Queen of Peace Baptism Register – Queen of Peace Church

Proposed Date of Baptism *

Time *

Email Address *

Phone *

Is this your first child receiving this Sacrament? *YesNo

Name of Child *

Street Address *

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

Date of Birth *

Place of Birth *

Father's Name *

Father's Religion *

Mother's First & Maiden Name *

Mother's Religion *

Parish of Parents *

Where were parents married (Church or other Location) *

Godfather First & Last Name *

Is the Godfather Catholic? *YesNo

Godmother First & Last Name *

Is the Godmother Catholic? *YesNo

Was child privately baptized? *YesNo