Child's Full Name*
Child's Middle Name*
Name of Parents*
, AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY
Email*
Phone*( ) -
Child's Date of Birth*
MM/DD/YYYY
Requested date(s) for baptism:*
Sanctuary - 8:30
Sanctuary - 11:00
Confluence - 11:00
Please select which service you'd like for the baptism.
Siblings
Please put age in parenthesis next to name.
Others who may sit with you during the service
Yes
No
