Baptism - January 26th

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Name

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Date of Birth

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Grade in School

Email

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This address will receive a confirmation email

Phone

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Address

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How would you like your name to read on your certificate?

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Who would you like to baptize you?

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Please select one option.

Robert Stokes, Lead Pastor Sal Sberna, Executive and Teaching Pastor Cory Johnson, Care and Community Pastor Taya Poveda, Director of Early Childhoos and Elementary Ministries David Newton, Director of Preteen and JR High Ministries Josh Ivie, The Gap Leader

Which service would you like to be baptized in?

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8:30 10:00 11:30

Shirt Size

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S M L XL 2X 3X

Are you over 18?

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Yes No

If no, please fill out parent/guardian information below

Name

Phone

Email

Description

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