Elementary
Middle School
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Adult
Your Name*
Email*
Phone( ) -
If you are a student, please fill out the contact information for your parent/guardian.
Parent/Guardian Name
Parent/Guardian Email
Parent/Guardian Phone( ) -
When and how did you come to trust Jesus Christ as your Lord and Savior?
Can you explain in your own words what baptism is?
Why do you want to get baptized?
A "hero" is someone who has helped you in your spiritual journey leading up to baptism. Who are your heroes? Can you invite them to your baptism?
What questions about baptism do you have?
Contact information for baptizer
Please provide the name and email / phone number for the person you'd like to baptize you.
If possible, who would you like to baptize you?
This person can be any baptized Christ-follower who was baptized after they made the decision to follow Christ, such as your group leader, a pastor, or family member.
Email
Do you require any special accommodations during your baptism? If yes, please explain.
We will reserve 6 seats for your family at the baptism. If you need more than this, please indicate the TOTAL number of seats you will need.
Are you new to reading the Bible? Would you like help getting started?
If you are a new believer, would you be interested in having a mentor?
T-shirt size
Full name to print on baptism certificate
