Baptism Interest
Complete the fields below and we'll be in touch with your next steps.
Today's Date:
/
Month
/
Day
Year
Your name
*
First
Last
Your email address
*
Your phone number
Please enter a valid phone number.
Who is interested in being baptized?
Me
My child
Are you over the age of 18?
*
Yes
No
What's your date of birth?
*
-
Month
-
Day
Year
This information is used for security purposes, to verify your Realm account.
Your Child's Name
*
First Name
Last Name
What's your child's date of birth?
*
-
Month
-
Day
Year
This information is used for security purposes, to verify your Realm account.
Your Parent's Name
*
First Name
Last Name
Your Parent's Email
*
Your Parent's Phone Number
*
Please enter a valid phone number.
May we include your parent on our communication about your baptism?
*
Yes
No
Submit
Should be Empty: