Baptism Application
Is the person being baptized UNDER 18?

Full Name: *

It will appear this way on your certificate
Phone *


Street, City, Zip Code
Shirt Size? *

Pants Size? *

Have you received Jesus Christ as your Lord and Savior? *

If so, When?

How long have you been attending this church?

Are you prepared to make a commitment to follow the Lord in Water Baptism? *

Under 18:

Name: *

Full name

Street, City, Zip Code
Age *


Shirt Size? *

Has your child received Jesus Christ as their Lord and Savior? *

Parent/Guardian's Name *

Parent/Guardian's Contact # *

Please tell us if you have any special needs or concerns:

Congratulations on making the decision to dedicate yourself through Water Baptism!