Water Baptism

If you, or your child, as a believer would like to participate in baptism by full immersion, please fill out the form below.

Name

Your name, or the name of the parent of the child requesting baptism.

First Name

Last Name

I am requesting baptism for:

Myself

My child/children

Email Address

Phone Number

Date Preference for Baptism

When would you like to schedule your baptism? We will try our best to accommodate your preference.

MM

DD

YYYY

Children

Child 1 Name

First Name

Last Name

Child 1 Age

Child 2 Name

First Name

Last Name

Child 2 Age

Child 3 Name

First Name

Last Name

Child 3 Age

Child 4 Name

First Name

Last Name

Child 4 Age