Fill out this form after scheduling your child's baptism with our priest or deacon. (You may call the office to schedule or email Frjoseph@catholicshrineatlanta.org or rjortiz@catholicshrineatlanta.org.)

Please enter the information carefully. We will use the information to create your child's Baptismal Certificate exactly as you have entered it.

Remember to press the SUBMIT button at the bottom of the form.

PART 1 of 4

This section is about the person being baptized.

First name

Middle Name(s)

Last name

Birthday

Month

Day

Year

City and State of Birth

Gender

PART 2 of 4

This section is about the parents of the person being baptized.

Parent 1 Full Name

Parent 2 Full Name

Phone

Yes, subscribe me to your newsletter.

Part 3 of 4

This section is about the godparents. You may have up to 4 godparents.

Name of Godparent 1

Name of Godparent 2

Name of Godparent 3

Name of Godparent 4

Will all Godparents be present at Baptism?

Yes

PART 4 of 4

This section is about the scheduled baptism. You must have already scheduled your baptism with the parish office (404-521-1866 or contactus@catholicshrineatlanta.org).

Name of Clergy baptizing your child

Scheduled date of Baptism

Scheduled Time of Baptism

Time

HoursMinutes

Remarks

Information for

Baptism Register

PART 1 of 4

PART 2 of 4

Part 3 of 4

PART 4 of 4

Catholic Shrine

The

of the

Immaculate Conception