Baptism Registration

Applicant First Name

Applicant First Name is required.

Applicant Last Name

Applicant Last Name is required.

Email

Email address is not valid

Email is required.

Mobile Phone

Mobile Phone is required.

Birth Date

Birth Date is required.

Gender

Male Female

Address

AL AK AS AZ AR CA CO CT DE DC FM FL GA GU HI ID IL IN IA KS KY LA ME MH MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND MP OH OK OR PW PA PR RI SC SD TN TX UT VT VI VA WA WV WI WY

Shirt Size

Youth Small Youth Medium Youth Large Adult Small Adult Medium Adult Large Adult XL Adult XXL Adult XXXL

Shirt Size is required.

Optional Baptism Class
July 19, 2026 - Room 204

• Student & Adults (6th Grade and up) | 9:00 am
• Children (5th Grade and under) | 10:45 am - Must Attend with a parent/guardian

Would you like to attend a baptism class?

Yes - July 19 | 9am students/adults Yes - July 19 10:45am child (must attend with a parent/guardian) No - I am unable to attend

How would you like your name to appear on the certificate?Baptism Certificate Name is required.

Who is Jesus to you?

Who is Jesus to you? is required.

Why do you want to get baptized?

Why do you want to get baptized? is required.

Anything else you would like to share with us?