St. Patrick's North Platte - Baptism Registration

Baptismal Registration Form

Go therefore and make disciples of all nations, baptizing them
in the name of the Father and of the Son and of the Holy Spirit,
teaching them to observe all that I have commanded you. (Mt 28:19-20)

Information about the CHILD to be baptized

Child's Full Name

Child's Date of Birth

City and State of Birth

United States

Another country (please specify)

Is the child adopted?

Please upload a copy of the child's birth certificate.

Birth Certificate

Information about the MOTHER of the child

Mother's Full MAIDEN Name

Mother's Religion

Information about the FATHER of the child

The father must be listed on the child's birth certificate. If no father is listed please leave this space blank or call the office.

Father's Full Name

Father's Religion

Information about the GODPARENTS

Please note that only ONE godparent is necessary. If there are two they must be one man and one woman.

Godfather's FULL name

The godfather is at least 16 years old and a Catholic in good standing who has received Baptism Confirmation and Holy Communion and who is living a life in keeping with the Church's teachings.

Godmother's FULL name

The godmother is at least 16 years old and a Catholic in good standing who has received Baptism Confirmation and Holy Communion and who is living a life in keeping with the Church's teachings.

If a godparent is coming from outside North Platte please submit a Letter of Good Standing from their pastor. You may also have the letter sent directly to the parish office.

Godparent Letter

Information about the CHRISTIAN WITNESSES (if any)

Full names:

The above person(s) is a baptized Christian.

General Information about the CEREMONY

Baptisms are usually held after Mass, you must verify the date/time with the parish office.

Preferred Date

Preferred Time

Preferred Language

Contact Information for the PARENTS

Full Mailing Address

Phone Number

I/we are registered at

Parents who are not from St. Patrick's North Platte must submit a letter of permission from their own pastor. Parents who are not registered anywhere will be asked to fill out a parish registration form.

Additional Comments?

I certify that the above information is true and accurate and that I have read and understand the parish policies. (required)

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Please fill this field.