Youth / Adult Baptism


    Full Name*:

    Birthdate*: (format mm/dd/yyyy)

    Mother's full name:

    Father's full name:


    Phone: (format XXX-XXX-XXXX)


    Are you a member of Glen Mar Church?

    If not, are you a member of another church?

    Would you like to become a member of Glen Mar Church?

    If you belong to another church, which church are you a member of?


    What date do you prefer for the baptism? It must be a 3rd Sunday of the month.

    At which service would you like the baptism to occur?