Baptism Form | Prairie Lutheran

Child's full name (first, middle,last) *

Gender *

Male
Female

Date of birth *

Place of birth *

Parents' full names (first, middle, last) *

Mother's maiden name *

Mailing Address *

Physical Address *

Best phone number(s) to reach you *

Email Address to reach you *

Members of which congregation *

Full names of sponsors *

Name(s) and age(s) of any siblings

Baptism date *

Congregation where the baptism will take place *

If it's being held at American Lutheran Church, we usually display a photo of the child on the PowerPoint presentation. Will you provide a photo? (If yes, please email the photo to office@prairielutheranparish.org) *

Yes
No

Pastor performing baptism *