Baptism Registration Name* First Last Email* Preferred Phone Number*Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Age*Under 1818+Please Select Your Age Group*9-12th Grade6-8th GradeK-5th GradeDo you believe you're going to heaven? Why do you believe that?*Please state briefly how and when you accepted Christ as your Savior.*Why do you want to get baptized? Have you been baptized before?*Please indicate your readiness.*I am ready to schedule my baptism.I need to speak with somone before I am ready to schedule my baptism. Please contact me.Video Release*Please read the Video Release, then check the box below to give Journey permission to show your video. I have read and agree to the Video Release. Minor Video Release*Please read the Video Release, then check the box below to give Journey permission to show your child's video. As parent or guardian of the registrant above, I have read and agree to the Video Release. Once you press "Submit" you will receive an email that explains the next steps in the baptism process.