Baptism Registration | Southside Church

First name

Last name

Phone

Email

Age

Signature of Parent or Guardian of individual being baptized if under 18 yrs of age

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Please list 3 friends or family you would like to invite to the Baptism service (Please Include: First & Last Name, Street, City, State, Zip Code)

Your Testimony (Please take time to share your story of what God has done in your life, for example the date you accepted Jesus as Lord of you life, where He has brought you from, what He has delivered you from, what He has restored in your life.)