Phone number *
Phone type Mobile Home Work Other
Gender *
Select… Male Female
Choose option that best fits individual being baptized: *
Select… Adult High School Student Middle School Student 2nd-5th Grade Student K-1st Grade Student Child not yet in school
Have you previously been baptized? *
Select… Yes - as a child or baby Yes - but not as a child or baby I have not previously been baptized
Are you being baptized with a friend or family member? Please type their name in the box below.
***** They will need to fill out a separate baptism form to be included ***** (we do not do multiple people in the tank at once, but, if you have a spouse, sibling or close friend you'd like to get baptized before or after - so you guys are close together, please list them here)
I am interested in being baptized on: *
Select… July 5th - Block Party
Which Baptism class will you be attending? *
Select… Wednesday June 24th - 5:00pm - Fireside Room Sunday June 28th - 10:00am - Fireside Room Other
Do you need any physical assistance getting in/out of the baptismal? *
Select… Yes No
Briefly share your story (How you came to Christ and why you want to be baptized) *
T-shirt Size *
Select… Youth Medium Youth Large Small Medium Large XL XXL XXXL
Photo and Live Stream Disclaimer
**** Pictures are taken of the baptisms as a way to celebrate and remember this momentous occasion in your spiritual walk. Baptsims are also live streamed - which is posted to our Facebook page. Live streams come off of Facebook after 30 days. We do not list your name with pictures or online as part of any posts that are made. If there are any concerns due to safety, please speak with one of our staff members at the baptism class. Thank you.
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