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Baptism Request
Your name
*
Last name
Email address
*
Phone number
*
Phone type
Mobile
Home
Work
Other
Parent(s) Name (if baptism request is a student)
Parent(s) Email (if baptism request is a student)
Address
*
T-shirt Size
*
Select…
Adult SM
Adult M
Adult LG
Adult XL
Adult 2XL
Child SM
Child M
Child LG
Child XL
Have you met with a staff member regarding baptism?
*
Select…
Yes
No
Baptism Date Request (at least 3 week notice is required)
*
Date
Is this date flexible?
*
Select…
Yes
No
Which service do you prefer to be baptized during
*
9:30am Service
11:00am Service
Why do you want to be baptized?
*
Who would you like to baptize you?
*
How has Jesus impacted your life?
*
Submit
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