Registration for Baptism
One per child
Name of child to be baptized
*
First Name
Middle Name
Last Name
Child's Birthdate
-
Month
-
Day
Year
Date
Preferred Baptism Date
-
Month
-
Day
Year
Date
8:00 or 10:30 service
AM
PM
AM/PM Option
2nd choice Preferred Baptism Date
-
Month
-
Day
Year
Date
8:00 or 10:30 service
AM
PM
AM/PM Option
Worship Service
8:00 a.m. (Sept-May)
10:30 a.m. (Sept - May)
9:00 a.m. (June-Aug)
Wednesday Chapel (School day)
Mother's Name
First Name
Last Name
Mother Member of Redeemer?
Yes
No
Redeemer Academy Parent
Mother's Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Mother's Phone Number
Please enter a valid phone number.
Mother's Email
example@example.com
Father'sName
First Name
Last Name
Father Member of Redeemer?
Yes
No
Redeemer Academy Parent
Father's Address (if different from above)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Father's Phone Number
Please enter a valid phone number.
Father's Email
example@example.com
Sponsor/s Name
First Name
Last Name
Sponsor/s Name
First Name
Last Name
Sponsor/s Name
First Name
Last Name
Submit
Should be Empty: