Baptism Registration Form

Register for Baptism on May 24th & the Baptism Class on Saturday, May 23rd

Baptism is an essential step of obedience that reflects our trust in Jesus for salvation. Following His example, we are immersed in water, symbolizing His death and burial, and then rise to celebrate His resurrection. Water baptism publicly declares three important truths: you are a follower of Jesus Christ, you are beginning a transformed life in Him, and you are part of a new family. If you or your child wish to be baptized, please fill out this form by Friday, May 15th to attend the Baptism Class on Saturday, May 23, 2026.
Full Name*

First NameMiddle NameLast Name
Birth Date*

MonthDayYear
Gender*
E-mail*
example@example.com
Mobile Number*
Format: (000) 000-0000.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please tell us about your salvation story*
Can you tell us about the day you invited Jesus into your heart?
Parent / Guardian Information if Applicable

First NameLast Name
E-mail
example@example.com
Mobile Number*
Format: (000) 000-0000.
Should be Empty:

Register for Baptism on May 24th & the Baptism Class on Saturday, May 23rd