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Baptism On-Line Registration

- Baptisms at St. Clare Church, Roseville, CA (916) 772-4717
  
  The maximum number of form submissions has been reached. This form is currently not available.
  
  The information recorded on this form is needed to record the baptism in the parish Baptism Register and to create the Baptismal Certificate. All information will be kept securely and will not be shared with any outside groups.
  
  ** Please only use legal names on this form**
  
  Date of Baptism
  Please select a date from the list below
  
  Child's Information
  
  Child's Name as it appears on Birth Certificate:
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Child's Gender REQUIRED Male Female Please fill out this field.
  
  Date of Birth: REQUIRED Please fill out this field. Please enter a date.
  
  Place of Birth:
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Family Information
  
  Family's Address REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Mother's Information
  
  Mother's Legal Name:
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Maiden Name REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Religion: REQUIRED Please fill out this field. Please enter valid data.
  
  Father's Information
  
  Father's Legal Name:
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Middle Name Please enter valid data.
  
  Father's Religion: REQUIRED Please fill out this field. Please enter valid data.
  
  Marriage Information
  
  Marriage Date: Please enter a date.
  
  Church Name: Please enter valid data.
  
  City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
  
  Other Venue: Please enter valid data.
  
  City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
  
  Godparents' Information
  
  At least one godparent must be a fully initiated (have celebrated Baptism, Eucharist and Confirmation) , practicing Catholic 16 years or older. The other can be from a Christian denomination formally recognized by the Catholic Church and will be listed as a witness. Please refer to guidelines for more details.
  
  Godfather's Legal Name:
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Godfather's Religion: REQUIRED Please fill out this field. Please enter valid data.
  
  Fully initiated? REQUIRED Please fill out this field.
  
  Godmother's Legal Name:
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Godmother's Religion: REQUIRED Please fill out this field. Please enter valid data.
  
  Fully initiated? REQUIRED Please fill out this field.
  
  Submit
  
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