Water Baptism Form September 27, 2026

September 27, 2026 @10:00AM | Please fill out this form and click submit.

Name

*

T-Shirt Size

*

Please select all that apply.

Youth - Large Adult - Small Adult - Medium Adult - Large Adult - X-Large Adult - 2XL Adult - 3XL

Address

*

Cell Phone

*

Email

*

This address will receive a confirmation email

Birthdate

*

I Have accepted Jesus Christ as my Lord and personal savior through the repenting of my sins.

*

Please select all that apply.

Yes No

If the box above is yes, then when?

*

Why do you wish to Get Baptized? (Mark One)

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Please select one option.

See the tub where I will be dunked. Want to show the world what God has done in my life. I like water. Like to swim in the Baptismal

Testimony: ( Please explain, in 3-5 Sentences, what your life was like before Jesus. How has God changed your life? How has it changed you?) * Your testimony will be read at the baptism service:

*

Photo/Media Consent

I understand that photos and/or video may be taken during this event. I give Central Assembly of God permission to use these images in church publications, on the church website, and on social media for promotional purposes.

Check One

*

Please select all that apply.

Yes, I consent. No, I do not consent. Option

Description

September 27, 2026 @10:00AM

Please fill out this form and click submit.

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