• Section I: Registration for English Baptism Classes Only

  • First Name * Please fill out this field. Please enter valid data.

    Last Name * Please fill out this field. Please enter valid data.
  • Family Email * Please fill out this field. Please enter an email address.
  • Phone Maximum 20 characters Please enter a phone number.
  • Address Line 1 * Please fill out this field. Please enter valid data.
  • Address Line 2 Please enter valid data.
  • City * Please fill out this field. Please enter valid data.
  • State / Province * Please fill out this field. Please enter valid data.

    Zip / Postal Code * Please fill out this field. Please enter a zip code.

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• Section II: Registration for English Baptism Classes Only

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  • Name of Child Being Baptized (please also submit a copy of the birth certificate to the rectory) REQUIRED Please fill out this field. Please enter valid data.
  • Family Home Address REQUIRED Please fill out this field.
  • Name of Father of Child Being Baptized REQUIRED Please fill out this field. Please enter valid data.
  • Father's Email REQUIRED Please fill out this field. Please enter valid data.
  • Father's Phone Number REQUIRED Please fill out this field. Please enter valid data.
  • Name of Mother of Child Being Baptized REQUIRED Please fill out this field. Please enter valid data.
  • Mother's Email REQUIRED Please fill out this field. Please enter valid data.
  • Mother's Phone Number REQUIRED Please fill out this field. Please enter valid data.
  • Mother's Religious Association REQUIRED (Select One) Practicing Catholic Non-Catholic Other Please fill out this field.
  • Father's Religious Association REQUIRED (Select One) Practicing Catholic Non-Catholic Other Please fill out this field.
  • Are parents married in the Catholic Church? (If not please provide details i.e. married civilly, in Christian church, never married etc.) REQUIRED Please fill out this field. Please enter valid data.
  • Parish Family is Currently Registered With: REQUIRED Please fill out this field. Please enter valid data.
  • Name of Godfather: REQUIRED Please fill out this field. Please enter valid data.
  • Godfather's Email REQUIRED Please fill out this field. Please enter valid data.
  • Godfather's Phone Number REQUIRED Please fill out this field. Please enter valid data.
  • Name of Godmother: REQUIRED Please fill out this field. Please enter valid data.
  • Godmother's Email REQUIRED Please fill out this field. Please enter valid data.
  • Godmother's Phone Number REQUIRED Please fill out this field. Please enter valid data.
  • Godfather's Religious Association REQUIRED (Select One) Practicing Catholic Non-Catholic Other Please fill out this field.
  • Godmother's Religious Association REQUIRED (Select One) Practicing Catholic Non-Catholic Other Please fill out this field.
  • Parish Godparents are Currently Registered With: REQUIRED Please fill out this field. Please enter valid data.
  • Preferred Baptism Date: (1st Sunday 3pm) REQUIRED Please fill out this field. Please enter valid data.
  • Session Dates - please pick 2 consecutive dates *must be in the same month* REQUIRED March 20, 2023 March 27, 2023 April 17, 2023 April 24, 2023 May 15, 2023 May 22, 2023 June 19, 2023 June 26, 2023 July 24, 2023 July 31, 2023 Please fill out this field.
  • Suggested Donation between $50 - $100 (Sacraments are free gifts of God's grace! All baptism donations go to the Maintenance Fund for St. Rose of Lima Church) REQUIRED $ Please fill out this field. Please enter a positive decimal.

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