Baptism Registration Form

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  Children over 7 years of age must attend the Rite of Christian Initiation for Children. The point of contact is the pastor or director of religious education. We ask that you register as a member of the IHM parish if you are not already so registered. If this is your first child, or if it has been 5 years since you last attended our Pre-Baptism session, you need to attend the Baptism Preparation Program.
  
  Child's Information
  
  Use FULL, PROPER, GIVEN names for the child, parents and Godparents. Middle names are required for the child and parents. No nicknames.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of birth REQUIRED Please fill out this field. Please enter valid data.
  
  Place of birth REQUIRED
  Please enter the city and state of the child's birth (example: Edgewood, KY). If not USA, please enter the country name.
  Please fill out this field. Please enter valid data.
  
  Patron Saint of Child
  If you have a preferred patron saint for the child, enter that saint's name here.
  Please enter valid data.
  
  Parent's Information
  
  Father's Name REQUIRED
  Enter complete father's first, middle and last name. If there are questions, please contact the Parish Secretary.
  Please fill out this field. Please enter valid data.
  
  Father's Religion REQUIRED
  Please indicate the Religion of the father (i.e. Catholic, Baptist, Lutheran, etc.)
  Please fill out this field. Please enter valid data.
  
  Mother's Name REQUIRED
  Please enter the mother's first, middle, and last names.
  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 enter the religion of the mother (i.e. Catholic, Baptist, Lutheran, etc)
  Please fill out this field. Please enter valid data.
  
  Residential 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.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Are the parents validily married? REQUIRED
  A Catholic party is bound to the Catholic form of marriage. This, in simplest terms, means that the marriage ceremony took place with a Catholic Priest or Deacon presiding. Contact us if you have any questions.
  Yes No Not Sure Please fill out this field.
  
  Date of Baptism Prep Session That You Will/Did Attend: (Everey other month: Jan, Mar, May, July, Sep, Nov)
  Enter month and year attended.
  Please enter valid data.
  
  Godparents
  
  One Godparent is required. If you have two, one must be male (godfather) and one female (godmother).
  
  Name of Godfather
  Confirmed, practicing Catholic over age 16)
  Please enter valid data.
  
  Name of Godmother Please enter valid data.
  
  Christian Witness
  If needed. This information is discussed during the pre-baptismal class.
  Please enter valid data.
  
  Requested Date for the Baptism (Note: This is requested, not guaranteed)
  
  Submit
  
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- Contact Us
  
  Kathy Donahue
  
  Parish Secretary
  
  (859) 689-5010, ext 224
  kdonahueihm-ky.org

Immaculate Heart of Mary
Catholic School

Burlington, Kentucky

Baptism Registration Form

Contact Us