Baptism Registration

Please fill out the form completely.
(One Per Applicant)

* Indicates required field

Name *

First

Last

Contact Number *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Please confirm the baptism service time *

11 am Service

Email *

Date of Birth *

Date of Salvation *

Would You Like A Pastor To Assist? *

By submitting this form, you are saying you believe Jesus Christ to be the Son of God and you have accepted Him as your own personal Savior. You desire to be baptized in water as a public profession of your faith in Christ. *

Submit

Please fill out the form completely.(One Per Applicant)

River of Life Church

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(One Per Applicant)