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Added: 10/13/2025
First Name
First Name cannot contain special characters such as quotes, parentheses, etc.
First Name cannot contain emojis or special fonts.
First Name is required.
Last Name
Last Name cannot contain special characters such as quotes, parentheses, etc.
Last Name cannot contain emojis or special fonts.
Last Name is required.
Email
Email address is not valid
Email is required.
Mobile Phone
Mobile Phone is required.
Birthdate
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Birthdate cannot be a future date.
Gender
Male
Female
Gender is required.
Have you trusted Jesus Christ as your Lord & Savior?
Yes
No
Not Sure
Have you trusted Jesus Christ as your Lord & Savior? is required.
Have you been baptized before?
No
Yes
Have you been baptized before? is required.
Do you have any physical issues that would prevent baptism? **REWORD?**
No
Yes
Do you have any physical issues that would prevent baptism? **REWORD?** is required.
Have you read Baptism by Larry Dryer?
No
Yes
Have you read Baptism by Larry Dryer? is required.
Briefly describe what the Bible calls "the gospel."
Briefly describe what the Bible calls "the gospel." is required.
Who is Jesus?
Who is Jesus? is required.
Give a brief description of your life before salvation.
Give a brief description of your life before salvation. is required.
How did you become a Christian?
How did you become a Christian? is required.
Briefly describe your life since you've come to Christ.
Briefly describe your life since you've come to Christ. is required.
During your Baptism, we will be taking pictures. Do we have your consent to post your pictures on our social media?
No
Yes
During your Baptism, we will be taking pictures. Do we have your consent to post your pictures on our social media? is required.
Submit