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.

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

Grade

1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th

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 12:15pm

Preferred Baptism Service 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 want to tell us?