Baby Dedication Request Form

Your Full Name

First Name Last Name

Email

example@example.com

Phone Number

Area Code Phone Number

Parents Full Names:

How many children?

1 2 3 4

Child/Children Full Name & Age

God Parent(s) Names:

Date Request (Please submit 3 possible dates)

Frequently Asked Questions About Baby Dedication:

Is there an age limit for a child to take part in a dedication service?

Our primary focus is on children age 4 and under.

Can a single parent participate in a baby dedication service?

Yes. We want to do all we can to encourage your walk with Christ. Single parenting is double duty in child rearing. As a church family, we desire to be part of your extended family. We hope to provide compassionate support, spiritual growth, and a variety of ministries to enable you to succeed in parenting your child in the nurture and admonition of the Lord.

Can the biological parents participate in a baby dedication service if they are not married?

No. While we honor the life of each child and encourage parents married and unmarried to embrace the importance of spiritual commitment for children, a baby dedication service is intended to reflect the teaching of Scripture on family life. Understanding the sacred honor of marriage as presented in God s Word, we believe every public act of worship is to conform to His standards. To fail to recognize and honor the specific teaching of Scripture on matters of family life would violate the integrity of our church and the Savior we serve. For those who are unmarried or living together, taking steps to acknowledge and surrender to God s plan for their individual lives would take precedence over participation in a baby dedication service.

Do you provide reserved seating for grandparents and extended family?

Yes. We would not want your family to miss this important event in your life. Photos are allowed.

Date of Birth

Male/Female

Male Female

Please indicate if you are:

Licensed Minister/Wife Leader Upcoming Leader

Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Phone Number

Area Code Phone Number

Church City

Condition of Health

Good Fair Poor

Do you have any health restrictions? Limitations? Please specify:

Emergency Contact (Name/Relation/Phone)

I, hereby assume personal responsibility for all risks associated with my or my child’s participation in Midwest Invasion 2021 activities and all activities participated in, while on or off the Victory Outreach property. These activities include but are not limited to all activities participated in. I am well aware that in attending and participating in Midwest Invasion 2021 my child or I, are doing it at our own risk. Knowing these facts, and in consideration of your acceptance of this release form, I hereby for myself, my heirs, executors, administrators, and anyone who might claim on my behalf, agree not to bring any claims and waive, release and discharge Victory Outreach, its agents, officers, staff, employees, coaches, or assigns from any and all claims or deaths arising out of, or in the course of my or my child’s participation in these activities. This release and waiver extends to all claims of every kind or nature whatsoever, foreseen or unforeseen, known or unknown. I am therefore willing to assume risk of and responsibility for such injury, damage or lost/stolen items which I (or any minor on whose behalf I am signing the release) may sustain arising out of the trip to and from Midwest Invasion 2021. etc. with Victory Outreach, its employees, agents, and other participants on the trip, or myself. I therefore agree to release, indemnify, and hold harmless Victory Outreach and its employees and agents from any liability, claims or causes of action arising out of or relatedin any manner to the trip which I take. I am assuming these risks and entering this release on behalf or myself, and my heir, executors, administrators and assigns. I understand in full capacity that all monies given, deposited, and paid to Victory Outreach, Travel Agencies or any other Organizations / persons that are going towards the trip to Midwest Invasion 2021 will be completely NON- REFUNDABLE & NON- TRANSFERABLE. I hereby agree to follow and uphold all verbal, writtenand posted rules, regulations and conducts of behavior. I am assuming the above risks and entering this Release on behalf or myself and any minor named and I am agreeing to its terms on my and, his or her behalf,as well as my, his or her executors, administrators and assigns.

Signature (I do hereby understand and agree to the above terms)

Clear

Baby Dedication Request Form

Wavier & Liability Release