Baptism Form

Please fill out this form if you would like to be baptized at our next available Baptism date.

Full Name:

Email Address

Mobile Phone:

I have committed my life to Jesus Christ, and I trust in Him for my salvation

yes no

Why do you want to be baptized?

Name of Staff member you would like have baptize you:

Which service time do you want to be baptized in?

T-Shirt Size

Adult Small Adult Medium Adult Large Adult XL

Submit