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 *
Parent Details
Parent's First Name *
Parent's Last Name *
Day-time Contact Number *
Email Address
Child's Details
First Name *
Last Name *
Date of Birth
Age
Gender
Postal Address
City/Suburb
Postcode
How long have you been a Christian (ie, having accepted Jesus Christ as your Saviour)?
Years
Months
Have you ever been baptised by immersion before?
Do you attend CityLife Church?
Where do you regularly attend CityLife Church?
Are you a member of a Life Group?
In your own words, please state why you desire to be baptised by immersion:


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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