Baptism Registration Name of child* First Middle Last Date of birth* Place of birth*Address* Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Phone*Email* Date of Baptism*Cannot choose a date within two weeks. Father's name* First Last Religion of Father*Mother's name* First Last Mother's maiden name*Religion of Mother*Were parents married by a Catholic priest?*YesNoGodfather* First Last Is Godfather Catholic?YesNoGodmother* First Last Is Godmother Catholic?*YesNoIs either Godparent represented by a proxy?*YesNoName of proxy*FirstLast Was the child privately baptized?*YesNoWas the child adopted?*YesNoName of priest* This iframe contains the logic required to handle Ajax powered Gravity Forms.