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Baptism / Sacrament Certificate Request Form

- Sacraments/Liturgy

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- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Reason for the request of the copy of the Baptismal Certificate REQUIRED Please fill out this field.
- Name of the Child/Person that was baptized REQUIRED Please fill out this field. Please enter valid data.
- Date of Birth of the Child REQUIRED Please fill out this field. Please enter a date.
- Date of Baptism Please enter valid data.
- Father's Name REQUIRED Please fill out this field. Please enter valid data.
- Mother's Name (Include maiden name) REQUIRED Please fill out this field. Please enter valid data.
- Name and Address of the Catholic Church in which the Baptism Certificate to be sent REQUIRED Please fill out this field.
- Date of Confirmation Please enter valid data.
- If you are requesting a Confirmation Certificate, please enter the mailing address.
- A copy of the baptismal certificate will only be sent and mailed to the Catholic Church of the requested.
  
    The copy of the baptismal certificate will be mailed to the requested Catholic Church within 10-14 Business days of the request.
  
    Person requesting a copy of a baptismal certificate for their own records must pick up the requested certificate in person from the parish office of St. Hyacinth. The Certificate will be available 10-14 Business days after the online request. The parish office will notify you when the certificate is ready.
  
    Person requesting the baptismal certificate MUST be either the parent of the child and or the child himself or herself who needs the baptismal certificate in preparation to receive a Sacrament in the Catholic Church.
  
    Request for copy of baptismal certificate only applies to St. Hyacinth Catholic Church. St. Hyacinth is not responsible for requesting baptismal certificates from other Churches.
  I Agree Please select this field.
- Authorization For Release of Information
  
  I hereby authorize St. Hyacinth Catholic Church to release a copy of requested Baptismal/ Confirmation Certificate.
  
  I agree to indemnify and hold harmless St. Hyacinth Catholic Church, its pastor and successors in office, and all other persons connected with them for any liability for releasing this information according to my request.
  I Agree Please select this field.
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