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Baptism Registration
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Work Entry
Added: 3/29/2026
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?
Submit