Bethel Baptism Form
Interested in being baptized? Great! Please complete the form below and a Bethel team member will reach out to you with next steps.
Person's Name Getting Baptized
*
First Name
Middle Name
Last Name
Person's Date of Birth
*
-
Month
-
Day
Year
Date
Person's Gender
*
Please Select
Male
Female
Phone Number
*
Optional
Format: (000) 000-0000.
Email Address
*
example@example.com
If the person is a minor, please provide Guardian's First and Last Name
First Name
Last Name
Guardian's Phone Number
Optional
Format: (000) 000-0000.
Guardian's Email Address
example@example.com
What campus would you like to be baptized at?
Grand Rapids, MI
Las Vegas, NV
How did you hear about us?
*
Are you a current Bethel Partner?
*
Any special prayer requests?
Optional
Please provide your T-Shirt Size
Anything else you'd like to share? Please provide any feedback, special accommodations or comments below.
Optional
Please upload a picture of the person being baptized
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Do you grant permission for photos of the baptism to be used for church publications or social media?
*
Yes
No
By signing below, you authorize and agree to participating in the baptism ceremony ceremony at Bethel Empowerment Church. You also authorize a Bethel team member to reach out to you regarding next steps.
*
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