October 7-8, 2017 Baptism Form
First and last name
Date of Birth
Your Email Address
Select which weekend service you would like to be baptized during.
6 pm - Saturday
9 am - Sunday
11 am - Sunday
Phone number (please include area code)
Mailing Address (include city, state and zip)
By completing this form you approve of the statements listed below. If you do not approve, please contact Georgeann Wearin at firstname.lastname@example.org, thank you!
I hereby give Cheyenne Hills Church (CHC) permission to take photographs and video of me, either by myself or in a group, for the purpose of publicity, advertising, or publishing.
I hereby give CHC permission to use my name, likeness, voice, and biographical material and exhibit/distribute, in whole or in part, without restrictions/limitations.
I hereby release and discharge CHC from any and all claims arising out of use of the photos/videos.
Guardian Name (for any applicant that is under the age of 18 listed above)
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