Baptism Infomation
Registration Contact
First Name
Last Name
Phone Number
Email Address
Child's Information
Child's Full Name
Date of Birth
Child's Sex
Child's Place of Birth
Parent Information
Mother's Full Name
Father's Full Name
Best Contact Number
Address (Street Address, City, State & Zip)
Service Information
Requested Date(s) of Baptism (Sundays Only)
Worship Service (Traditional or Anchor)
Preferred Pastor for Baptism
Number of Attendees (Estimate)
Submit