Child Dedication Request
We're so excited you have decided to take this next step in your family. Please fill out this form and we will get back to you soon with further details.
Parent Name
*
First Name
Last Name
Parent email
*
example@example.com
Child Name
*
First Name
Middle Name
Last Name
Child birth date
*
-
Month
-
Day
Year
Date
Child Name
First Name
Middle Name
Last Name
Child birth date
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Month
-
Day
Year
Date
Child Name
First Name
Middle Name
Last Name
Child birth date
-
Month
-
Day
Year
Date
Preferred Dedication Date:
*
Upload a picture of the child being dedicated that is ok to use on screens in service.
*
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