WATER BAPTISM REGISTRATION

Your name *

Email address *

I wish to take the next step in my journey and be water baptized. *

Name of Candidate *

Date

Gender

Marital Status

Birthday *

Phone Number

Address *

I have committed my life to Jesus Christ, and I trust Him for my salvation. *

Yes

Baptism requirement for anyone age 7-17:

By checking this box, as a parent/legal guardian, I acknowledge that I am giving Harvest permission to baptize my child.

Name of Parents/Guardian

Attention:

After submitting your email address, please make sure to submit form under the name of the individual who is to be baptized, not as the one filling out the application.

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