Baptism registration form

Baptism Registration

“Those who accepted his message were baptized” – Acts 2:41

Please fill out this form to be scheduled for baptism.

Baptism Request

First Name

Last Name

Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Gender

Date of Birth

T-Shirt Size

I understand what believer's baptism is and want to be baptized as a public declaration of my allegiance to Jesus:

YES

Have you accepted Jesus Christ as your personal Lord and Savior:

YES