Baptism Form
Baptisms are held the last Sunday of every month following the 11:30 AM service.
Name (Person being Baptized)
*
How would you like your name to read on your certificate?
*
Email
*
This address will receive a confirmation email
Phone
*
Address
*
--
AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Date of Birth
*
Shirt Size
*
Please select one option.
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Adult XL
Adult 2XL
Adult 3XL
Select Option
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Adult XL
Adult 2XL
Adult 3XL
Over 18?
*
Please select all that apply.
Yes
No
Parent Name (if under 18)
Grade in School
Please indicate the month in which you are requesting to be Baptized.
Month & Date
*
Please select one option.
April 30th
May 28th
Select Option
April 30th
May 28th
Submit
Description
Baptisms are held the last Sunday of every month following the 11:30 AM service.
×
Please Fix the Following