Sign Up for Baptism - Create Church

Baptism Signup

Name*
First Last
Date of Birth*
MM slash DD slash YYYY
Email*
Phone*
Address*
Please provide your address to receive your baptism certificate by mail.

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
I have accepted Jesus Christ as my Lord and Savior*
- Yes
- No, I would like to meet with a member of the church staff to discuss it further
Do you have any special needs or accommodations?
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