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Infant Baptism Request Form

Infant Baptism (for Ages 6 Years Old and Under)
- The maximum number of form submissions has been reached. This form is currently not available.
  
  **If you are requesting Baptism for a child that is 7 years or older, please contact the Baptism Coordinator directly at (757) 937-6712 or email at [email protected].**
  
  Baptism Request Form
  
  Are you a registered parishioner at Holy Family? REQUIRED Yes No Please fill out this field.
  
  If "No", please complete a parish registration form by printing it out from this link
  https://www.holyfamilyvb.org/new-here and return it to the parish office.
  
  Child's Information
  
  Child's First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Middle name Please enter valid data.
  
  Child's Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth* REQUIRED Please fill out this field. Please enter a date.
  
  Age REQUIRED Please fill out this field. Please enter valid data.
  
  City and State of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Information
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's FULL Maiden Name REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Father's Information
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Father's Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Home Address and Contact Information
  
  Street 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.
  
  Contact Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Best days and times to reach me: REQUIRED Please fill out this field. Please enter valid data.
  
  Alternate Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Have you attended a Baptism class in the past 3 years? REQUIRED Yes No Please fill out this field.
  
  If yes, please indicate month and year: Please enter valid data.
  
  Message:
  
  Submit
  
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Church of the Holy Family

Catholic Church

Infant Baptism Request Form

Infant Baptism (for Ages 6 Years Old and Under)

Baptism Request Form

Child's Information

Mother's Information

Father's Information

Home Address and Contact Information