Child's Full Name:
Birthplace (City/State):
Date of Birth:
Father's Full Name:
Is the Father Catholic? Yes No
Mother's Full Name (include Maiden Name):
Is the Mother Catholic? Yes No
Sponsor #1:
Is Sponsor #1 Catholic? Yes No
Sponsor #2:
Is Sponsor #2 Catholic? Yes No
Are you a registered member of Our Lady of the Chesapeake?
Yes No
Are the parents of the child to be baptized married? Yes No
Date attending baptism program:
Your Name:
Mailing Address (Street, City, State, zip code):
E-mail Address:
Home Phone:
Work Phone (Father):
Work Phone (Mother):
Comments/Questions:
Someone from our Pastoral Staff will contact you to schedule a date and time for the baptism.
Back to Baptism
