BAPTISM INFORMATION

Our Savior's Lutheran Church 1035 Carol Lane, Lafayette, CA  94549

Please complete all the information you can. The information from this form will be used to officially record the baptism in the Parish Register, and to produce a Certificate of Baptism and Certificates of Sponsorship for your use.

Full name of the person to be baptized:

Date of Birth (DD/MM/YYYY):   Gender: MaleFemale

Place of Birth: 

Parent / Guardian 1:

Name: 

Current Church Affiliation: 

Parent / Guardian 2:

Name: 

Current Church Affiliation: 

Address: 

Contact Info:   

Other children in the family who have been baptized at Our Savior's:

Sponsors'/Godparents'names as you would like them to appear on the certificate:

Preferred Date for Baptism (MM/DD/YYYY): 

Preferred Pastor (if any): 

Will the baptism be at Our Savior's? YesNo

If no, where?