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Sacraments
Baptism
Pre-Baptism Registration

Baptism Registration Form

Thank you for your interest in having your child baptized at Immaculate Heart of Mary Parish. Please complete the form below as thoroughly and accurately as possible.

After your form has been submitted, a member of our parish staff will review the information and contact you regarding scheduling, Baptism preparation, and any additional documentation that may be required.

Before You Begin

Please have the following information available:

Child’s full legal name
Child’s date and place of birth
Parent contact information
Names of the proposed godparent(s)
Religious affiliation of the parents
Information regarding any previous Baptism preparation completed by the parents

Godparent Requirements

Please note:

At least one godparent must be a practicing Catholic.
Catholic godparents must be eligible according to Church law and may be required to obtain a Letter of Suitability from their pastor.
If two godparents are chosen, one must be male and the other female.
A baptized non-Catholic Christian may serve as a Christian Witness alongside a Catholic godparent.

For complete godparent requirements, please review our Baptism Information Page.

Important

Submission of this form does not schedule a Baptism date. A member of the parish staff will contact you to finalize preparation requirements and arrange the celebration of the sacrament.

Baptism Information

Requested Date of Baptism(Required)

MM slash DD slash YYYY

When will this baptism take place?(Required)

During Mass

Outside Mass

Which Mass would you prefer?(Required)

4:00 PM

8:00 AM

10:00/11:00 AM

Note: During the months of May-August, our last Sunday Mass is at 10:00 AM. The remainder of the year, the last Sunday Mass is at 11:00 AM.

Requested Time of Baptism(Required)

AM/PM

Note: Recommended time for Saturday is 11:00 AM or 12:00 PM. We cannot do after mass on Saturday evening or after 8:00 AM mass on Sunday due to the mass schedule.

Requested Clergy for Baptism(Required)

Pastor (Rev. Fr. Andrew Boyd)

Deacon (Rev. Mr. Edgar Gonzalez)

Other

Child's Information

Child's Name(Required)

First Middle Last Suffix

Child's Date of Birth(Required)

MM slash DD slash YYYY

Child's Place of Birth (City Name)(Required)

Was the child privately baptized for reason of emergency?(Required)

Yes

Was the child adopted?(Required)

Yes

Parental Information

Are both parents rightful custodians of this child?(Required)

Yes

Please contact the parish office to complete this form.

Father's Full Name(Required)

First Middle Last Suffix

Father's Religious Affiliation(Required)

Roman Catholic

Eastern Catholic

Orthodox

Protestant

Other Christian

Non-Christian Religion

No Religion

Other

Does the Father actively practice his religion?(Required)

Yes

Father's Address(Required)

Street Address Address Line 2 City State ZIP Code

Father's Email(Required)

Father's Cell Phone Number(Required)

Mother's Full Name(Required)

First Middle Last Suffix

Mother's Religious Affiliation(Required)

Roman Catholic

Eastern Catholic

Orthodox

Protestant

Other Christian

Non-Christian Religion

No Religion

Other

Does the Mother actively practice her religion?(Required)

Yes

Mother's Address(Required)

Street Address Address Line 2 City State ZIP Code

Mother's Email(Required)

Mother's Cell Phone Number(Required)

Were the parents married according to the Catholic Church?(Required)

Yes

Have the parents completed the Baptism Preparation Course?(Required)

Yes

Godparent Information

At least one godparent must be a practicing Catholic. Before the baptism, that godparent must obtain a letter from their pastor confirming that they are an active, practicing Catholic and are eligible to serve as a godparent.

Godfather's Name(Required)

First Last

Is the Godfather an actively practicing Catholic?(Required)

Yes

Godmother's Name(Required)

First Last

Is the Godmother an actively practicing Catholic?(Required)

Yes

Is either Godparent represented by a proxy?(Required)

Select between 1 and 2 choices.

Godfather

Godmother

Godfather Proxy Name(Required)

First Last

Is the Godfather Proxy an Actively Practicing Catholic?(Required)

Yes

Godmother Proxy Name(Required)

First Last

Is the Godmother Proxy an Actively Practicing Catholic?(Required)

Yes

Declaration and Signature

Signature(Required)

I certify that the information provided on this form is true, complete, and accurate to the best of my knowledge. By signing below, I affirm that this information has been provided in good faith for the preparation and celebration of the Sacrament of Baptism.

Today's Date(Required)

MM slash DD slash YYYY

Questions?

Please contact the parish office at (724) 662-2999 if you need assistance completing this form or have questions regarding Baptism or godparent eligibility.

Registration Submitted

Thank you for submitting your Baptism Registration Form.

A confirmation email has been sent to you. A member of the parish staff will review your submission and contact you regarding Baptism preparation, required documentation, and scheduling.

Please note: Submission of this form does not automatically schedule a Baptism date.