Baptism of a Child Request Form

Child's Details

Christian Names *

Last Name *

Date of Birth *

Proposed Date of Baptism

Parents Details

Mother's Full Name *

Mother's Phone *

Mother's Email *

Occupation *

I Undertake, by God's help, to ensure that this child is instructed in the Christian faith by word and good example, and to encourage him/her to learn to worship God, to pray to him, to trust in him, and to take part in the life of the church. *

I agree

Father's Full Name *

Father's Phone *

Father's Email *

Occupation *

I agree

Home Address *

Marriage of Parents

Date

Place

Godparents

Name of Godparent 1 (leave blank if not needed)

Name of Godparent 2 (leave blank if not needed)

Name of Godparent 3 (leave blank if not needed)

Name of Godparent 4 (leave blank if not needed)