EmailMe Form - 2024 REQUESTS FOR WATER BAPTISM

INFORMATION CONCERNING BAPTISM

Every candidate must be a born-again believer.

Children must have a permission form (attached to the baptism registration) signed by a parent or guardian.

Every candidate must have a change of clothes/towel.

To avoid exposure when wet, every candidate must wear black or dark pants and shirt. *NO shorts, skirts, skorts, or dresses.

Please meet in the Intersection building for 7:45 a.m.

The service will begin PROMPTLY at 8:30 a.m.

Candidates arriving late are not guaranteed participation in the service.

Next Baptism Service will be Saturday, October 5, 2024 *

Saturday, October 5, 2024

Are you and/or your child current and active member(s) of Word of Restoration International Church? *

If you chose 'other' please specify:

Baptism Candidate's Name: *

First Middle Last

Multiple Choice *

Male

Female

Candidate's Date of Birth *

MM / DD / YYYY

Parents

*Please complete, ONLY if candidate is a minor.

Name of Parent *

First Last

Name of Parent

First Last

Contact Information

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Primary Contact # *

### - ### - ####

Secondary Contact #

### - ### - ####

Email Address *

1) I am requesting that Word of Restoration water baptize me by immersion.
-OR-
2) I/We are requesting Word of Restoration to water baptize my/our child by immersion. PLEASE NOTE: A parent and/or guardian must accompany any minor and be present for the baptism ceremony.

I/We hereby release WORIC and anyone connected therewith (including Apostle Charles and Lady Charlette Perry) from all liability that could be connected with this request and acknowledge that I have the proper authority to request WORIC to perform this baptism on me or my child's behalf.

Candidate's Printed Name [for Certificate] *

First Middle Last Suffix

Candidate Signature (Parent Signature if candidate is a minor) *

Clear

Please sign above using your computer mouse or fingertip for touch-enabled devices.