Baptism Request Form


Today's Date *
Today's Date
Child's Information
Please list your child's full name as you would like it to appear in the bulletin and on the baptism certificate.
Child's Gender
Child's Date of Birth *
Child's Date of Birth
Parent Information
Please list the mother's name as you would like it to appear in the bulletin and on the baptism certificate.
Please list the father's name as you would like it to appear in the bulletin and on the baptism certificate.
Phone *
Phone
Address *
Address
Baptism Service
Please select during which service you would like to have your child baptized
Desired Baptism Date *
Desired Baptism Date
Date must be confirmed by the church