I WANT TO GET BAPTIZED! *

First Name

Last Name

Phone *

(###)

###

####

What local church do you attend? *

The Pastors from these three churches are organizing Baptize Lodi, but the event is open to any church.

Gravity Church

Revelation Church

Vintage Church

I don't have a church

other church (please list below)

Do you want a Pastor to follow-up with you before June 8? *

Yes

No