Baptism Registration Form

Please complete the following information ONLY if your child is to be baptized at St. Theresa Catholic Church, Austin, Texas. (For baptism in other parishes, please request a Baptism preparation certificate.) If you only plan to attend the Baptism Preparation Session at St. Theresa, you must call the Parish Office at 512-451-5121 so you may add your name to the list.

The date for Baptism can be set by calling the Church Office (Mon-Fri 9am-5pm) at 512-451-5121. Do not plan on a specific date for Baptism until you have checked with the Parish Office for availability of that date.

Baptisms are generally done each weekend, depending on the priest/deacon’s schedule.

CHILD'S INFORMATION:

Child First Name REQUIRED Please fill out this field. Please enter valid data.

Child Middle Name REQUIRED Please fill out this field. Please enter valid data.

Child Last Name REQUIRED Please fill out this field. Please enter valid data.

Child Date of Birth REQUIRED Please fill out this field. Please enter valid data.

Child Place of Birth REQUIRED Please fill out this field. Please enter valid data.

RESIDENCE INFORMATION:

Street 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.

CONTACT INFORMATION:

Email REQUIRED Please fill out this field. Please enter an email address.

Phone Number 1 REQUIRED Please fill out this field. Please enter a phone number.

Phone Number 2 REQUIRED Please fill out this field. Please enter a phone number.

FATHER'S INFORMATION:

Father's First Name REQUIRED Please fill out this field. Please enter valid data.

Father's Middle Name REQUIRED Please fill out this field. Please enter valid data.

Father's Last Name REQUIRED Please fill out this field. Please enter valid data.

Father's Religion REQUIRED Please fill out this field. Please enter valid data.

MOTHER'S INFORMATION:

Mother's First Name REQUIRED Please fill out this field. Please enter valid data.

Mother's Middle Name REQUIRED Please fill out this field. Please enter valid data.

Mother's 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.

GODPARENTS' INFORMATION:

Godfather's First Name REQUIRED Please fill out this field. Please enter valid data.

Godfather's Middle Name REQUIRED Please fill out this field. Please enter valid data.

Godfather's Last Name REQUIRED Please fill out this field. Please enter valid data.

Is Godfather Catholic? REQUIRED Yes No Please fill out this field.

Godmother's First Name REQUIRED Please fill out this field. Please enter valid data.

Godmother's Middle Name REQUIRED Please fill out this field. Please enter valid data.

Godmother's Last Name REQUIRED Please fill out this field. Please enter valid data.

Is Godmother Catholic? REQUIRED Yes No Please fill out this field.

Is either Godparent to be represented by a proxy? REQUIRED Yes No Please fill out this field.

If yes, indicate name of proxy: Please enter valid data.

Was the child privately baptized? REQUIRED Yes No Please fill out this field.

Was the child adopted? REQUIRED Yes No Please fill out this field.