Baptism Registration

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(One Per Applicant)

* Indicates required field

Name *

First

Last

Contact Number *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Email *

Date of Birth *

Date of Salvation *

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

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River of Life Church of God

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(One Per Applicant)