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Baptism Request Form

Infant Baptism (for Ages 6 Years Old and Under)
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  Baptism Request Form
  
  Are you a registered parishioner at Holy Family? REQUIRED Yes No Please fill out this field.
  
  If you "No", please complete a registration form by stopping by the parish office during business hours.
  
  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.
  
  City and State of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  *If you are requesting Baptism for children 7 years and older, please contact the parish office at (757) 481-5702.
  
  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 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.
  
  Baptism Request Date
  Masses not listed are already full. Please choose from the dates below:
  
  First Choice for Baptism Date
  
  Second Choice for Baptism Date
  
  Sign-Up for Baptism Class
  
  Baptism class is done asynchrousnously using the Belonging program from Ascension Press. The Baptism coordinator will respond to your online request and at that time give you the information to access the course.
  
  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:
  
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Church of the Holy Family

Catholic Church

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

Baptism Request Date

Sign-Up for Baptism Class