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Grades 1-6
Sunday Morning
Wednesday Night
Events
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Grades 7-12
Sunday Morning
Wednesday Night
Events
Gallery
College/Career
Sunday Morning
Events
Gallery
Awana
Clubs
Club Calendar
Club Directors
Register
Heart-to-Hand
Events
Leadership
Volunteer
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Child Protection Policy
Signature Page
Background Check
New Christians
Growth Guide
Request Baptism
Events
Summer Camp 2025
Menu
Grades 1-6
Sunday Morning
Wednesday Night
Events
Gallery
Grades 7-12
Sunday Morning
Wednesday Night
Events
Gallery
College/Career
Sunday Morning
Events
Gallery
Awana
Clubs
Club Calendar
Club Directors
Register
Heart-to-Hand
Events
Leadership
Volunteer
Request To Volunteer
Child Protection Policy
Signature Page
Background Check
New Christians
Growth Guide
Request Baptism
Events
Summer Camp 2025
BAPTISM REQUEST FORM
Baptism Request Form
BAPTISM CANDIDATE'S NAME
*
NAME
*
WHAT DATE (MUST BE A SUNDAY) WOULD YOU LIKE THE BAPTISM TO TAKE PLACE? (MM/DD/YYYY)
*
WHAT SERVICE TIME IS PREFERABLE FOR YOUR FAMILY?
*
9:30 am
11:00 am
Either is fine
ENTER CANDIDATE'S NAME EXACTLY AS IT SHOULD APPEAR ON THE BAPTISM CERTIFICATE:
*
WHICH PASTOR WOULD YOU PREFER TO PERFORM THE BAPTISM CEREMONY?
*
Kevin Corey (NextGen Pastor)
Dave Rhodenhizer (Senior Pastor)
SCHOOL GRADE?
*
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
HAS THE BAPTISM CANDIDATE MADE A PROFESSION OF FAITH IN JESUS CHRIST?
*
Yes (see next field)
No
Unsure
IF YOU ANSWERED "YES" ABOVE, PROVIDE THE DATE, AGE, OR ANY INFORMATION THAT PERTAINS TO THE CANDIDATE'S PROFESSION OF FAITH:
*
PARENT/GUARDIAN NAME
*
NAME
*
ADDRESS (WHERE YOU WOULD LIKE THE CERTIFICATE TO BE MAILED):
*
Single Line Text
*
City
*
State
Zipcode
*
Country
*
EMAIL
*
PREFERRED PHONE
*
COMMENT
*
If you are human, leave this field blank.
Submit
X
X