Name *

How you would like it to appear on your Baptism certificate

First Name

Last Name

Phone *

(###)

###

####

Have you committed your life to Christ and do you trust Him for your salvation? *

Yes

No

When? *

MM

DD

YYYY

Choose A Pastor To Baptize You *

Pastor Matt Stewart

Pastor Brad Shedd

Pastor Bill Sparkman

Pastor Skye Stewart

Other