Baptism Request
Water Baptism is a public, outward declaration that reflects a personal, inward faith. It associates the believer with the death, burial, and resurrection of Jesus Christ, and signifies the believer's death to the old life and his or her resurrection as a new creation in Christ (Romans 6:1–8; Colossians 2:12, 2 Corinthians 5:17).
Name of person being baptized
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Have you accepted Jesus Christ as your Savior?
*
Yes
No
Select Adult if 18 years+ OR Child if under 18 years of age
*
Adult
Child
Email
*
example@example.com
Phone Number
*
PARENTS (if child is under 18), complete the following child who is being baptized:
Parent's Name
First Name
Last Name
E-mail
example@example.com
Phone Number
Notes or questions
Submit
Should be Empty: