Baptism Form

If you confess with your mouth Jesus as Lord, and believe in your heart that God raised Him from the dead, you will be saved. Romans 10:9

Please fill out this form and click submit.

Full Name

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Phone

*

Email

This address will receive a confirmation email

If Child: Age:

If Child: Father's Name

If Child: Mother's Name

Date Preferred (Please note: forms filled out on Fridays or Saturdays aren't processed until the following Monday.)

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Which Service?

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Please select one option.

Sunday 9am Sunday 11am Sunday 6pm Wednesday 7pm Other Day, fill out below in Other Day/Time

Other Day/Time:

Which Pastor would you like to do the baptism?

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Please select one option.

Pastor Doug Pastor Cody Pastor Shaun Other (please list below)

Other:

Do you have any questions about baptism?

Have you confessed Jesus as Lord of your life?

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Please select all that apply.

Yes No

Do you believe God raised Him from the dead?

*

Please select all that apply.

Yes No

Special Information (i.e. medical conditions, etc.)

T-Shirt Size

Please select all that apply.

Child Small Child Medium Child Large Adult Medium Adult Large Adult XL Adult XXL

Description

If you confess with your mouth Jesus as Lord, and believe in your heart that God raised Him from the dead, you will be saved. Romans 10:9

Please fill out this form and click submit.

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