If you would like your child to be prayed over and dedicated to the Lord, please fill out this form.
Once we have reviewed it a Pastor will be in contact with you.
Child's Name
*
First Name
Last Name
Child's Birthdate
*
-
Month
-
Day
Year
Date
What service would you like?
*
8:30am Service
10am Service
Parent's Name and info
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Is it ok to text the above phone number?
*
Please Select
Yes
No
Email
*
example@example.com
Submit
Should be Empty: