Name *

First Name

Last Name

Phone *

(###)

###

####

Name of Baptism Candidate (if different from above)

First Name

Last Name

Gender *

Male

Female

Has the baptism candidate made a decision to follow Christ? *

Yes

No

T-Shirt Size of Baptism Candidate *

S

M

L

XL

XXL

Are you and/or the baptisms candidate a regular attender of The Lighthouse Church? *

Yes

No

I understand that I must read theLighthouse Water Baptism booklet, as well as attend a brief informational meeting at 9:20am on the morning of the baptism service. (The booklet can be obtained by clicking the link below.) *

Yes, I understand