Baptism Scheduling Form We are excited that you have chosen Liberty Barn Church for your child’s baptism. Please fill out the information below and we will be in contact soon. "*" indicates required fields Date requested* MM slash DD slash YYYY Baptisms are normally celebrated the second and fourth Sundays of the month.Alternate date choice* MM slash DD slash YYYY Baptisms are normally celebrated the second and fourth Sundays of the month.Child's Full Name* First Middle Last Child's Date of Birth* MM slash DD slash YYYY Child's Gender* Female Male Child's Birthplace*Mother's Name* Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Middle Last Suffix Type name as you would like them to appear in the bulletin.Mother's Maiden Name*Father's Name* Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Middle Last Suffix Type name as you would like them to appear in the bulletin.Email* Enter Email Confirm Email Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home Phone*Work Phone (Mother)*Work Phone (Father)*Names and Ages of Other Family ChildrenNameBirth DateBaptism Date Add RemoveHave you read the vows of Baptism above, and do you feel prepared to take them on behalf of your child?* Mother - Yes Mother - No Have you read the vows of Baptism above, and do you feel prepared to take them on behalf of your child?* Father - Yes Father - No Are you currently a member of Liberty? (Or regularly attend?)* Yes No If not, do you plan to join Liberty? Yes No Church Membership, if other than LibertyChurch NameChurch PhoneDate Joined Add RemoveIf you are not currently a member and will not be joining Liberty, please list the name, phone number, and the date you joined the church of which you are currently an active member.In which church family do you intend to raise your child?Sponsor InformationNameAddressPhoneEmail Add Remove“A Sponsor (referred to as a Godparent in some traditions) is a person, who agrees to assist in the nurturing of a baptized child in their faith. If you have chosen such a person or persons for your child, please complete the information below, and indicate whether they plan to be present at your child’s baptism.”Will the sponsor be present at your child’s baptism? Yes No Unsure CommentsThis field is for validation purposes and should be left unchanged. Δ