Baptism Registration

First Name

First Name is required.

Last Name

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.

Marital Status

Married Single Divorced Widowed

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

Is the person getting baptized in 5th grade or younger?

Yes No

Is the person getting baptized in 5th grade or younger? is required.

Which baptism class would you like to attend?

I've already attended a class. Adults/Students - 3/1/26 12pm Children - 3/1/26 10:45am I cannot make any of the scheduled times.

Which baptism class would you like to attend? is required.

Shirt Size

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

Shirt Size is required.

How you want your name to appear on your certificate?Baptism Certificate Name is required.

Preferred Baptism Service

4/4/26 5:00pm 4/5/26 9:00am 4/5/26 10:45am 4/5/26 12:15pm

Preferred Baptism Service is required.

Tell us about your life before Jesus. How did He come into your life and how has your life changed?

Tell us about your life before Jesus. How did He come into your life and how has your life changed? is required.

Anything else you want to tell us?