Baptism Request
Please fill out the fields below for the individual that is being baptized. We ask that parents please fill out this information on behalf of children under 17 years.
* Required
Today's Date
*
MM
/
DD
/
YYYY
First Name
*
Your answer
Last Name
*
Your answer
Email
*
Your answer
Cell Phone
*
Your answer
Address
*
Your answer
City, State and Zip Code
*
Your answer
Requested Date of Baptism
*
Sunday, October 20, 2019
Required
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