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Baptism & Baptism Class Registration
Name of child to be baptized:
______________________________________________________
(First)
______________________________________________________
(Middle) (Last)
Date of Birth _____/_____/_____ Circle one - M / F
Place of Birth _______________________________________
Child lives with: (circle one)
Both Parents Mom Dad Other __________________
Father's Name:
______________________________________________________
(First) (Middle) (Last)
______________________________________________________
(Religion)
Mother's Name:
______________________________________________________
(First) (Middle) (MAIDEN)
______________________________________________________
(Religion)
Family Information:
______________________________________________________
(Address)
______________________________________________________
(City) (State) (Zip Code)
______________________________________________________
(Phone)
______________________________________________________
(Email *required)
Date of Baptism _____/_____/_____
(confirm after attending baptism class)
______________________________________________________
(Godfather's Name)
* at least one Godparent must be a practicing Catholic and 16 years old
______________________________________________________
(Godmother's Name)
* at least one Godparent must be a practicing Catholic and 16 years old
I/We plan to attend class on _____/_____/_____
First child to be baptized? ______Yes ______ No
Ages of other children _______________________________
St. Gerald Catholic Church - 7859 Lakeview St, Ralston, NE 68127
Phone:(402)331-1955 - Fax:(402)339-8733