Baptism Form

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Baptism Form

Church 21 Baptism Form

* Indicates required question

Personal Information

First & Last Name *

Your answer

Sex *

Your answer

Age *

MM

/

DD

/

YYYY

Email *

Your answer

Phone Number *

Your answer

T-Shirt Size (for Baptism shirt) *

XS

S

M

L

XL

XXL

Do you authorize Church 21 to publish photos of your baptism on their social media sites? *

Yes

No

Which location do you attend? *

Downtown

Verdun

South Shore

West Island

Have you already been baptized? *

Your answer

Do you regularly attend another church other than Church 21? If so, which one? *

Your answer

Are you part of a Church 21 City Group? If yes, who are the leaders of the group? *

Your answer

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