Baptism Registration

Child's Name*
First Middle Last
Child's Date of Birth*
Date Format: MM slash DD slash YYYY
Child's City of Birth*
Address*
Street Address Address Line 2 City State ZIP / Postal Code
Phone*
Parent Email*
Enter Email Confirm Email
Father's Name*
First Middle Last
Father's Religion*
Mother's Name*
First Middle Maiden Name
Mother's Religion*
Church/Place of Marriage*
Godfather's Name*
First Last
Godfather's Religion*
Godmothers's Name*
First Last
Godmother's Religion*
Date of Baptism Class*
Please indicate if you have attended the baptism class at St. Agatha. If not, when do you plan on attending? It is offered 5 times each year, usually on the third Sunday of January, March, May, August, and October.