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Baptism Interest Form

Interested in getting water baptized? Please fill out the information below, and a Campus Pastor will follow up with you shortly.

Your name *

Last name

Email address *

Phone Number *

Phone type

Best way to contact you? *

Phone Call

Text Message

All baptism forms must be completed and submitted no later than 4pm on Thursday before the scheduled baptism date; this will allow our pastors plenty of time to meet with individuals and prepare for the upcoming baptism event. *

By checking this box I understand the above statement.

Have you previously been baptized? *

Yes

Date of Previous Baptism

Guess if needed.

Name of church you were baptized in:

Officiating Pastor's Name:

Are you a parent registering on behalf of your child? If so, please provide their name below.

Please select your age range, OR the age range of the person interested in being baptized. *

12 years and younger

13-18 years

19 +

Gender *

Person being baptized

Male

Female

How would you (or this child) like to be baptized? *

What service time are you (or this child) interested in being baptized at? *

Have you (or this child) accepted Jesus Christ as your Lord and Savior? *

Yes

What size shirt do you (or this child) wear? *

Tell us a little bit about what led you (or this child) to the decision to be baptized? *

Is there anything you would like for us to be aware of before following up with you?

The Gathering Place Church
andra@gpchurch.tv
205-640-2715

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