EmailMe Form - Beach Baptism

Name *

First Last

Birthday *

MM / DD / YYYY

If under 18, enter your Grade below. If over, enter N/A *

Email *

Phone *

### - ### - ####

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Have you prayed a prayer like this?

“Dear God, thank you for making me and loving me, even when I've ignored you and gone my own way. I realize I need you in my life and I'm sorry for my sins. I ask you to forgive me. Thank you for dying on the cross for me. Please help me to understand you more. As much as I know how, I want to follow you from now on. Please come into my life and make me a new person inside. I accept your gift of salvation. I am a follower of Christ. Please help me to grow now as a Christian.”

*

Yes

No

Please read these scriptures as you prepare to be baptized

Matthew 10:32; Matthew 28:18-19; Acts 2:38; Acts 22:16; 2 Corinthians 5:17

In a few sentences share your testimony of how Jesus has changed your life. **This will be read as you are baptized.** *

Who has been influential in your Spiritual Walk towards Jesus and how have they influenced you? *

I have accepted Jesus Christ as my Savior & Lord & I desire to follow Him all the days of my life. *

Clear

*Please use your mouse (or finger on a mobile device) to sign your full name in the box.

Will you need assistance getting in and out of the ocean *

Yes

No

If Minor (17 or under), have parent sign here and fill out fields with Mother's and Father's name.

Clear

*Please have parent type full name on line.

Mother's Name

First Last

Father's Name

First Last

Is there anything else you would like us to know?