Child’s Firstname *

Child’s Surname *

Child’s Date of Birth *

Child’s Address *

County / Postcode *

Is this child Baptised?

Yes Catholic
Other Christian Denomination
Child NOT Baptised

Church of Baptism

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Other Church Address

Date of Baptism

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Teacher’s Name

Mother's / Guardian's Firstname *

Mother's / Guardian's Surname *

Father's / Guardian's Firstname

Father's / Guardian's Surname

Primary Contact Mobile Phone Number *

Primary Contact Email *

Consent and Agreement *

I understand and give my consent

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