Resurrection Baptism Request Form
Welcome!
We are excited to be contacted for a baptism. Deacon Ed or Deacon Dan will be contacting you soon to discuss the baptism and baptism prep, if needed. As a reminder, when selecting Godparents, only one is required, but all Godparents must be confirmed, practicing Catholics. A Christian witness can also be part of the baptism if there is only one Godparent.
I am requesting baptism for:
*
Please Select
Unborn child
Newborn child
Child
Myself
other
Name of person to be baptized
*
First Name
Middle Name
Last Name
Suffix
Due Date (If baby is not born yet.)
-
Month
-
Day
Year
Date
Resurrection has a "New Mom" meal train that will provide some meals for the family after a child is born. Would you like the meal train coordinators to set up meals for your family? If so, they will be provided your preferred contact information and will reach out to you directly.
Please Select
Yes, I would like to be contacted to receive meals.
No, I am not interested.
Date of Birth
-
Month
-
Day
Year
Date
City of Birth
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Father's Full Name
*
First Name
Middle Name
Last Name
Suffix
Father's Religion
*
Mother's Full Maiden Name (Please put your Maiden last name!)
*
First Name
Middle Name
Last Name
Mother's Religion
*
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Preferred Phone Number
*
Please enter a valid phone number.
Second Phone Number
Please enter a valid phone number.
Preferred Email
*
example@example.com
Second Email
example@example.com
Are parents are registered parishioners of Resurrection?
*
Please Select
Yes
No
Do you want to register as a parishioner? (We strongly encourage this so you can stay informed of parish activities and to keep track of sacramental information.)
Please Select
Yes. (We will email you a link to sign-up or you can do it on our parish website)
No
Godfather/Witness name
*
First Name
Last Name
Godfather/Witness's Religion
*
Godmother/Witness name
First Name
Last Name
Godmother/Witness's Religion
Baptism preparation class or an individual meeting with a deacon is for the parents is required prior to a child's baptism unless you have met done so previously. Have you previously completed a baptism prep class or meet with a deacon @ Resurrection?
*
No. (Meeting with deacon is required prior to baptism.)
I have watched Fr. Mike Schmitz's Ascension Press video on baptism but did not meet with a deacon. (Meeting with a deacon is required prior to baptism.)
I have watched Fr. Mike Schmitz's Ascension Press video on baptism and met with a deacon. (No prep class or meeting with a deacon is required prior to baptism.)
Yes, I met with one of the deacons at their monthly baptism prep class. (No prep class or deacon meeting required.)
Yes, I met with one of the deacons individually. (No prep class or meeting with a deacon required.)
Preferred month to attend baptism prep class at Resurrection
*
Please Select
January
February
March
April
May
June
July
August
September
October
November
December
Desired Date of Baptism (We will check availability of that day and get back to you soon)
*
-
Month
-
Day
Year
Date
Desired time for baptism
*
Following Saturday 5pm Mass
Following Sunday 10:30am Mass
Desired Presider
*
Fr. Jerry Pratt
Deacon Dan Niemeier
Deacon Ed Walker
I have no preference.
I have asked clergy from another parish to do the baptism here.
Preferred method of contact from deacon:
*
Email
Text
Phone Call
Submit
Should be Empty: