Name of Person to be Baptized/Chrismated

    Place of birth


    Date of birth

    Date of Baptism

    Fathers Name

    Fathers Religion

    Mothers Name

    Mothers Religion

    Address of person to be baptized or, if a child, address of parents




    The Godmother

    By Whom Baptized

    Name to be taken at Baptism

    **Please provide the following: 2 towels, cross, candle and a change of clothes (white).

    There is no charge for any sacrament or church service; however, it is customary to make charitable donations to the serving clergy in gratitude for the extra time and effort they put into performing additional services.

    An example sentence is:

    • Baptism – recommended donation of $250.

    This example should not be interpreted as a “price list” or as defining or limiting your contribution.
    Make a voluntary donation according to how God has blessed you.

    For all questions, you can personally contact the rector, Father Sergiy.

    Contact information:

    • Phone: (757)515-8442
    • Email address:

    Donation for baptism:

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