Baptism Request Form

Please use this form to submit a request to reserve the church for a Baptism Service.

Please note submitting this request does not secure a reservation. The request will be reviewed and you will be notified with next steps.

Person Completing Form

Name

This address will receive a confirmation email

Phone

Address

Relationship to Person Being Baptized

Person Being Baptized Information

Is this an adult or a child baptism?

If this is a child baptism, please provide the parents names.

Name of Person Being Baptized

Date of Birth

Requested Baptism Name

Requested Baptism Date

Comments

Optional Donation

There is no fee for any church service. If you would like to you can make an optional donation to the church. May God bless you.

Payment

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Description

Please fill out this form and click submit.

Baptism Request Form

Description

Please Fix the Following