Name (Required)

Email Address (Required)

Phone Number

Address

How long have you been attending RHPC? (Min. 6 months)

Tell us your story. Why do you want to be baptized in water?

I have accepted Jesus as my personal Saviour and I am a born again Christian (Required)

I am a regular attender of RHPC and have been for a minimum of 6 months (Required)

I will be attending the Water Baptism Class prior to being water baptized (Required)

I understand water baptism does not make me a Christian or a Church Member (Required)

I am not getting baptized in water to support immigration or refugee claims (Required)

Place of Birth

Date of Birth

Father's Name

Mother's Maiden Name

Anything else you would like to share?