Baptism Information Request

Baptism Information Request

Please fill out the form below and someone will connect with you to answer any questions you may have and to schedule your baptism.
Name*

First NameLast Name
Email*
example@example.com
Phone Number*

Area CodePhone Number
Date of Birth*

MonthDayYear
Campus*

RaytownLee's Summit
Age*

ChildTeen (13-18)Adult (19 & up)
Date I'd like to be baptized:

Sunday, June 9 - Lee's Summit CampusSunday, June 16 - Raytown CampusSunday, July 21Sunday, August 18Sunday, September 15Sunday, October 20Sunday, November 17
Do you have any questions?
Should be Empty: