Please complete the following information, which will be used to enable us to process your baptism application and issue a certificate.

Where would you like to get baptised? *
Date of Baptism *
First Name *
Last Name *
Date of Birth
Marital Status

Postal Address
Day-time Contact Number *
Other Contact Number
Email Address

Please answer the following:

How long have you been a Christian (ie, having accepted Jesus Christ as your Saviour)?
Have you ever been baptised by immersion before?
Do you attend CityLife Church?
Where do you regularly attend CityLife Church?
Do you attend a Life Group?
Please share a brief testimony that led you to your decision to be baptised by immersion: *
Would you like to nominate a Christian family/friend to baptise you?

By submitting this form I hereby consent and agree for me and/or my child(ren) to be filmed by the CityLife Church media team and for my and/or my child(ren)'s image and likeness to be shown in video promotions on the screens at CityLife Church and the CityLife Church website. I understand I will receive no compensation for this filming and the footage may be used in perpetuity.
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