HC Baptism Registration

1
Date of baptism service you wish to register for* This field is required.
Date
Month
Day
Year
2
Which service will you attend* This field is required.Private baptisms must be approved by a Pastor before scheduled.
8am Gathering
9:30am Gathering
11:30am Gathering
3
Registrant Name* This field is required.
4
Individual seeking baptism is* This field is required.
a Minor
an Adult
5
Parent Name (If Minor)
6
Parental Consent for Baptism of Minor
Clear
7
Registrant D.O.B.* This field is required.Select Month, Year, then Day
Date
Month
Day
Year
8
T-Shirt Size
Please Select
Please Select
YS
YM
YL
YXL
S
A
M
L
XL
XXL
9
Address* This field is required.
10
City, State, Zip* This field is required.
11
Phone Number* This field is required.Type 10 digits, no characters
12
E-mail* This field is required.
example@example.com
13
How long have you attended Harbor Church?* This field is required.
14
Additional family/friends attending baptism service(approximate, if known)
Please Select
Please Select
0
1
2
3
4
5
6
7
8
9
10
10+
15
Have you received Jesus as your personal Lord and Savior?* This field is required.
Yes
No
16
Give a brief testimony of your salvation experience.* This field is required.
Huge
Large
Normal
Small
Ok
Ok
17
Additional Notes or Questions
Huge
Large
Normal
Small
Ok
Ok
Should be Empty: