Baptism Request Form

Please complete the following form to start the process for baptism. A church staff member will be contacting you soon for further coordination of steps. Thank you!

Your name *

Email address *

Preferred Sunday Baptism Date (first choice)

Preferred Sunday Baptism Date (second choice)

Service Time Preference for Baptism *

Please check all that apply

10:00 am service

Full Name of Person to be Baptized: *

Please include first, middle, and last names.

Should you be requesting more than one baptism, feel free to complete a separate form for each individual or you can enter full names, birthdates, and ethnicities of additional persons in the comments section at the bottom. A church staff member will adjust the baptism request.

Birthdate of Person to be Baptized: *

Ethnicity of Person to be Baptized: *

(For statistical purposes only)

Parent/Guardian Information

The following questions are for the parent/guardian(s) of a child to be baptized or for self if an adult baptism request.

Parent/Guardian Name (s): *

Address *

Phone Number *

Preferred method for The Harvest staff to reach you: *

Please check all that apply

Phone call

Other

General comments:

Acknowledgement *

I acknowledge that completing this form is a request for baptism and that I will be contacted by The Harvest staff for further coordination. Completing this form is not a guarantee of date or time preference, though all efforts will be taken to match availability.

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