Water Baptism Registration
Please fill out the name portion the way you would like for it to appear on your baptism certificate!
First Name
Last Name
Phone Number
Email
What age group do you fall in?
Elementary
Middle School
High School
18+
If participant is younger than 18 years of age, please provide Parent/Guardian information
Parent/Guardian 1 First + Last Name
Parent/Guardian 1 Phone Number
Relationship
Parent/Guardian 2 First + Last Name
Parent/Guardian 2 Phone Number
Relationship
We have a gift for you! What size t-shirt do you wear?
Youth S
Youth M
Youth L
Youth XL
S
M
L
XL
2XL
3XL
4XL
Which 2025 Baptism date works best for you?
April 6
May 4
June 1
July 6
August 3
September 7
October 5
November 2
December 7
How many will be joining us for breakast?
Have you surrendered your heart to Christ?
Yes
No
Please share your salvation story below
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