Bulletin Plus :: Church Form

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Baptism Form

Please complete this form if you are interested in being baptized. Be advised that your requested baptism date is not confirmed until you've received a confirmation email from Centerpoint. A staff member will contact you shortly to begin the process of scheduling a baptism. Please contact our office at (334) 356-3076 with any questions.
Full Name:
Gender
Date of Birth (mm/dd/yy)
Parent/Guardian Name(s)

if under the age of 18
Phone Number
Email
Address
City, State Zip
Preferred Baptism Date & Service Time
Who would you like to perform your baptism?
T-shirt Size:
Do you need seats reserved for friends/family? If so, how many?
Please explain briefly why you want to be baptized:

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