Baptism - August 25th
Please fill out this form and click submit.
Name
*
Date of Birth
*
Grade in School
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
How would you like your name to read on your certificate?
*
Who would you like to baptize you?
*
Please select one option.
Robert Stokes, Lead Pastor
Sal Sberna, Executive and Teaching Pastor
Cory Johnson, Care and Community Pastor
JJ Wells, Next Gen Pastor
Taya Poveda, Kids Ministry Director
Select Option
Robert Stokes, Lead Pastor
Sal Sberna, Executive and Teaching Pastor
Cory Johnson, Care and Community Pastor
JJ Wells, Next Gen Pastor
Taya Poveda, Kids Ministry Director
Which service would you like to be baptized in?
*
Please select one option.
8:30
10:00
11:30
Select Option
8:30
10:00
11:30
Shirt Size
*
Please select one option.
S
M
L
XL
2X
3X
Select Option
S
M
L
XL
2X
3X
Are you over 18?
*
Please select one option.
Yes
No
If no, please fill out parent/guardian information below
Name
Phone
Email
Submit
Description
Please fill out this form and click submit.
×
Please Fix the Following