Baptism Registration Ceremony Day/Time Preference*Saturday – Private, 10:30amSaturday – Private, 11:15amSaturday – Private, 12:00pmSunday – Group, 2pmThis is not a hold or a guarantee.Ceremony Language* English Spanish Bilingual Was the Child Already Baptized in an Emergency?*NoYesIf Yes, When?* MM slash DD slash YYYY Child's InformationFull Name of Child* First Middle Last Child's Date of Birth* MM slash DD slash YYYY Place of Birth* City State / Province / Region AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Is Child Adopted? No Yes Contact InformationHome Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Primary Phone*Secondary PhonePrimary Email* Enter Email Confirm Email Secondary Email Enter Email Confirm Email Parent's InformationFather's Full Name* First Middle Last Father's Religion*Catholic – Roman/Latin RiteCatholic – Eastern RiteChristianOtherPlease Specify:* Mother's Maiden Name* First Middle (Maiden Last Name) Mother's Religion*Catholic – Roman/Latin RiteCatholic – Eastern RiteChristianOtherPlease Specify:* Parent's Marital StatusMarital Status*Married in the Catholic ChurchMarried Civilly OnlyDivorcedSeparatedNot MarriedSingle ParentName of Church* Parish RegistrationParish Registration Status* COTLF Parishioner Registered at Another Parish Please register me as a new COTLF Parishioner Envelope Number* What Parish Are You Registered At?* Godparent's OptionsGodparents Selection* Both a Godmother and a Godfather Only a Godfather Only a Godmother Godfather's InformationGodfather's Full Name* First Middle Last Name of the Church where Godfather is Registered and Active:* Godfather's Religion*Catholic – Roman/Latin RiteCatholic – Eastern RiteChristianOtherGodfather's Sacramental History* Baptized Received First Holy Communion Confirmed Married Check all that apply.Marriage Information* Married in the Catholic Church Married Civilly Only Name of the Church Where Godfather was Married:* Godmother's InformationGodmother's Full Name* First Middle Last Name of the Church where Godmother is Registered and Active:* Godmother's Religion*Catholic – Roman/Latin RiteCatholic – Eastern RiteChristianOtherGodmother's Sacramental History* Baptized Received First Holy Communion Confirmed Married Check all that apply.Marriage Information* Married in the Catholic Church Married Civilly Only Name of the Church Where Godmother was Married:* Proxy Information (If Applicable)Is Either Godparent Being Represented by a Proxy?NoYes, the GodmotherYes, the GodfatherBoth Godparents will be Represented by ProxyProxy Name* Second Proxy Name* Consent* We agree.Both parents consent to have the child named above Baptized into the Roman Catholic Church at Church of the Little Flower, Coral Gables, FL. All supporting documentation is required in order to reserve/schedule a Baptism Date.CAPTCHAEmailThis field is for validation purposes and should be left unchanged. Share This To:
