Reborn Form

Baptism enrollment form.

Name of Child(Required)

First Middle

Date of Birth(Required)

Child Resides With(Required)

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Name of Father(Required)

First Last

Religion of Father(Required)

Name of Mother(Required)

First Last

Religion of Mother(Required)

Guardian(Required)

First Last

Religion(Required)

Reborn Course Dates

All classes meet from 6:30 to 8:00 PM in the Parish Hall. Both parents are required to attend if in the same home as the child. Babies are welcome to attend! There is no fee to register. Session 1: June 4, 11 & 18, 2019 Session 2: September 3, 10 & 17, 2019 Session 3: December 3, 10 & 17, 2019 Session 4: March 3, 10 & 17, 2020 Session 5: June 2, 9, & 16, 2020

Reborn Course Dates(Required)

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