Baptism Registration

First Name

Last Name

Email

Mobile Phone

Birth Date

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

Which baptism class would you like to attend?

I've already attended a class. Adults/Students - 10/05/25 12pm I cannot make any of the scheduled times.

Shirt Size

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

How you want your name to appear on your certificate?

Baptism Service

11/16/2025 9am 11/16/2025 10:45am

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

Anything else you want to tell us?