Participant's Information *

First Name

Last Name

Phone *

(###)

###

####

Is participant an adult, student, or kid? *

Adult

Student (5th-12th Grade)

Kid (Kindergarten-4th Grade)

Parent Name

If you're a parent of a child or student getting baptized, please provide your name and contact information here:

First Name

Last Name

Phone

(###)

###

####

Baptism Class *

Choose your date

Sunday, October 26, 11:45am

Wednesday, November 5, 7:00pm