EmailMe Form - Baptism Registration Form

Full Name: *

Type your name as you want it to be on the Water Baptism Certificate

Date of Birth: *

MM / DD / YYYY

Gender *

Male

Female

Phone: *

Email: *

Address (certificates will be mailed) *

Street Address City State / Province / Region Postal / Zip Code

Be sure to include apartment or unit number if necessary.

Is this a new address? *

Yes

No

Which class will you be attending? *

Baptism Class: Adult

Baptism Class: Young Believers (for children 9-12 years old)

*Parents participating in baptism may attend the Young Believers class with their child.

I would prefer to be baptized during the: *

Saturday 5:00pm

Sunday 9:30am

Sunday 11:30am

I am flexible

Shirt Size (adult sizes) *

How long have you been attending Water of Life Community Church? *

Are you currently in a Small Group? *

Yes

No

If yes, name of leader:

Will other members of your family be baptized at the same time? *

Yes

No

If yes, please list their names and relationship to you below:

**These individuals must still complete their own registration form**

Do you have any special needs or disabilities we should be aware of?

Have you surrendered your life to Jesus to trust and follow Him as your Lord and Savior? *

Yes

No

Who, besides the Holy Spirit, most influenced you to become a follower of Jesus? *

Have you ever been baptized before? *

Yes

No

If yes, when?

Share Your Story of Faith

Parents/Guardians, you can help your child fill out this section:

Describe what your life was like before you believed in Jesus, including events in your life that helped you realize you needed Jesus. *

Describe what happened when you surrendered control of your life to Jesus and began following Him. *

What is Jesus doing in your life now? Describe how your life has changed since you began truly following Jesus. Include what he has been teaching you recently. *

Name

First Last

Unique ID