Baptism Request Form

Being baptized is an important part of the journey of each person’s faith. If you are considering baptism for yourself or your child, please complete and submit the form below. Someone will then contact you to set up an appointment with one of our pastor.

NOTE: During the baptism, we would like to display a picture of the person being baptized on our worship screens. Please forward a picture to use during worship to samantha.woodruff@christunited.com.

Today's Date

YYYY

Child's Information

Child's Full Name

Please list your child's full name as you would like it to appear in the bulletin and on the baptism certificate.

Child's Gender

Male

Female

Child's Date of Birth

YYYY

Parent Information

Mother's Name

Please list the mother's name as you would like it to appear in the bulletin and on the baptism certificate.

Father's Name

Please list the father's name as you would like it to appear in the bulletin and on the baptism certificate.

Email Address

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Baptism Service

Service Location

Please select during which service you would like to have your child baptized

Desired Baptism Date

Date must be confirmed by the church

YYYY

Pastor Preference

Which pastor would you like to perform the baptism?