Baptism Class Registration - Philadelphiaec

Baptism Class Registration

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone Number *

Email *

DOB *

Gender:

Male
Female

Have you accepted The Lord Jesus Christ as your personal Savior ? If yes, please provide the date? *

Yes
No

Date of Conversion *

Sunday School Class *

Sunday School Teacher *

Emergency Contact

Layout

Name *

Relationship *

Address if different from yours *

Address Line 1

Address Line 2

City

State

Zip Code

Phone Number *

Layout

Signature

Date *

Psalm 119:105

Your word is a lamp for my feet, a light on my path

The Lord is my shepherd; I shall not want.
Psalm 23:1

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