Baptism Form - Purpose House Church

First Name *

First name of baptismal candidate

Last Name *

Last name of baptismal candidate

Phone number *

Date of Birth *

Date requested for baptism *

T-Shirt Size *

Child/Youth 10-12

Child/Youth 14-16

Adult Small

Adult Medium

Adult Large

Adult XL

Adult 2X

Adult 3X

Adult 4X

Adult 5X

Please describe your spiritual background (raised in church, religious affiliation, no church or religious affiliation, etc.) *

Please describe your experience when you accepted Christ. What led you to accept Him? How has your life been impacted by this decision? *

REQUIRED FOR BAPTISMAL CANDIDATES UNDER 18 YEARS OLD: I/We give our consent for (child's name) to be baptized in water by immersion.

Name of Parent(s)/Legal Guardian(s) Authorizing