Catholic Baptism Information

Today's Date*

MonthDayYear

Email*

example@example.com

Requested date is not guaranteed. After submission, someone from our office will contact you to verify the time and date of your child's baptism.

If you have questions, please call the parish office at 620.231.2135

Mass Time*

Saturday after 4:30pm MassSunday after 12:00pm (noon) Mass

Requested Date of Baptism*

MonthDayYear

Name of child*

First NameMiddle NameLast Name

Birth Date*

MonthDayYear

Gender

MaleFemale

Place of Birth*

Street Address

Street Address Line 2

CityState

Father's Name (as listed on Birth Certificate)

First NameMiddle NameLast Name

Father's Phone

Area CodePhone Number

Father's Address

Street Address

Street Address Line 2

CityState

Zip Code

Father's E-mail (if different than above)

Father's Religion

Father's Parish

where you are a member

Street Address

Street Address Line 2

CityState

Language(s) Spoken

EnglishSpanishOther

Mother's Name

First NameMiddle NameLast Name

Maiden Name

Mother's Phone

Area CodePhone Number

Address Same as Father?

YesNo

Mother's Address

Street Address

Street Address Line 2

CityState

Zip Code

Mother's Email (if different than above)

example@example.com

Mother's Religion

Mother's Parish

where you are a member

Street Address

Street Address Line 2

CityState

Language(s) Spoken

EnglishSpanishOther

Are Parents Married?*

YesNo

If yes, were they married in the Catholic Church*

YesNo

Various answers to these questions do not prevent one's child from Baptism. Yet, in order to help best foster a Catholic environment of growth, we encourage parents to know that one is unable to receive Confession or Communion while living with a boyfriend/girlfriend. So if this is the case, please see your pastor to talk about being married in the Catholic Church.

Was the baby privately baptized?*

YesNo

When?

MonthDayYear

Have parent(s) ever attend a Baptism class?*

YesNo

Was the baby adopted?*

YesNo

I/We promise to strive to live the Catholic Faith to the best of my/our ability through family prayer, reception of the Sacraments, and weekly attendance at Holy Mass.

Father

Father's Electronic Signature

Please type first and last name.

Today's Date

MonthDayYear

Mother

Mother's Electronic Signature

Please type first and last name.

Today's Date

MonthDayYear

NOTICE! Catholic Church Law (Canons 873 & 893) requires pastors and parents to ensure proper selection of Godparents (or sponsors). So please, only choose Godparents according to these specifications:

They cannot be the parents of the one to be Baptized or Confirmed.
They must be Catholics who have received the Sacrament of Confirmation.
They must be at least 16 years old.
One or two Godparents may be chosen.
- If there are two, they must be a male and a female.
- They may either be both married to each other or a man from one marriage and woman from another marriage.
- If married, they must be married in the Catholic Church (not just civilly).
They must be free from canonical penalty and must lead a life in harmony with the faith in keeping with the function to be undertaken.
- They must not be living with a partner romantically outside of marriage.
- They should attend Mass regularly and frequently receive the sacraments of Confession and Holy Communion.
A Christian not of the Catholic Faith may be chosen as a witness, but only in conjunction with a Catholic Godparent

Godfather's Name

First NameLast Name

Non-Catholic Christian Witness?

YesNo

Phone Number

Area CodePhone Number

Address

Street Address

Street Address Line 2

CityState

Zip Code

Parish

where he is a member

Street Address

Street Address Line 2

CityState

Godmother's Name

First NameLast Name

Non-Catholic Christian Witness?

YesNo

Phone Number

Area CodePhone Number

Address

Street Address

Street Address Line 2

CityState

Zip Code

Parish

where he is a member

Street Address

Street Address Line 2

CityState

I affirm and I understand the responsibility of choosing worthy Godparents according to the criteria above.

I also understand that I will need to have the Godparent(s) fill out a permission form from their parish if they are members of another parish other than Our Lady of Lourdes, and have them return it at least one week before the Baptism date.

I/We Agree*

Parent's Signature*

Please type first and last name.

Parent's Signature

Please type first and last name.

Date

MonthDayYear

Submission of this form does not constitute a completely scheduled baptism. Completion of a baptism class is required by one or both parents BEFORE the baptism is scheduled.

Baptism classes are held the first Saturday of each month from 11:00am-Noon.

Priest Signature

Date

Baptism Information

Child's Information

Father's Information

Mother's Information

General Information

Parent(s) pledge to faithfully live the Catholic Faith:

Godparent (or Sponsor) Information

Godfather Information

Godmother Information