Please enable JavaScript in your browser to complete this form.Child's Name *FirstMiddleLastDate of Birth *Place of BirthRequested Range of Dates for BaptismFather's Name *FirstLastFaith Relationship *ChristianOther FaithNon-ReligiousMember of congregationMother's Name *FirstLastFaith Relationship *ChristianOther FaithNon-ReligiousMember of congregationHome Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeContact Phone Number *Email *Siblings Names and AgesGodparentsThose who will stand with parents and commit to helping raise the child in the Christian faith.Photographic Files of Child Click or drag files to this area to upload. You can upload up to 4 files. Photographs that can be projected during the baptismal service.WebsiteSubmit