Summer Outdoor Baptism
Registration Form
Name
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Phone Number
Please enter a valid phone number.
Email
example@example.com
Mailing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Emergency Contact
First Name
Last Name
Emergency Contact Phone Number
Please enter a valid phone number.
T-Shirt Size
Please Select
Small
Medium
Large
XL
2X
3X
Have you accepted Jesus Christ as your Lord and Savior?
Please Select
Yes
No
I'm still exploring
Are you a member of The Park? (Not required for baptism)
Please Select
Yes
No
If no, do you attend another church? Optional: List Church Name
Do you need assistance understanding what baptism means?
Please Select
Yes
No
Preferred method of contact for follow-up:
Please Select
Phone Call
Text Message
Email
Submit
Should be Empty: