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  • Mother's Name (first and 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.
  • Father's Name (first, middle and last name) REQUIRED Please fill out this field. Please enter valid data.
  • Email REQUIRED Please fill out this field. Please enter an email address.
  • Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  • Is this your first child being Baptized? If yes, a Baptismal prep class is required REQUIRED Yes No Please fill out this field.
  • Child's Name (first, middle and last) REQUIRED Please fill out this field. Please enter valid data.
  • Child's date of birth REQUIRED Please fill out this field. Please enter valid data.
  • Child's place of birth (city and state) REQUIRED Please fill out this field. Please enter valid data.

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