Baptism Request Form

Baptism Information

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Child's First Name

Child's Middle Name

Child's Last Name

Child's Birth Date

Child's Birth Place

Gender

Male

Female

Baptism Date

Would you like to use the fellowship hall for a reception/family meal?

Yes

No

Parent's Information

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Father's First Name

Father's Last Name

Father's Cell

Father's Email

Mother's First Name

Mother's Last Name

Mother's Cell

Mother's Email

Address

Address Line 1

Address Line 2

City

State

Zip Code

Godparent Information

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First Name

Last Name

Relation to Baptized

First Name

Last Name

Relation to Baptized

First Name

Last Name

Relation to Baptized

First Name

Last Name

Relation to Baptized

Family Information

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Sibling's Name

Last Name

Sibling's Age

Sibling's School Grade

Sibling's Name

Last Name

Sibling's Age

Sibling's School Grade

Sibling's Name

Last Name

Sibling's Age

Sibling's School Grade

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