Baby Dedication Request

BABY DEDICATION REQUEST FORM
If you would like to have a child dedicated at Zion Hope Church, please submit one request form per child. PLEASE PRINT CLEARLY and submit this form to the church by mail, fax, email or in person

Zion Hope Church Attn: Edna Rogers 5950 E. 46th Street Indianapolis, IN 46226

Phone: (317) 547-4397 Fax: (317) 545-8817

Email: info@zionhopechurch.org
CHILD'S INFORMATION
Child's Full Name
MaleFemale
Birthday
Hospital where child was born?
Parents Information
Parent Name(s)
(Please include City, State and Zip)
Email Contact
example@example.com
Mobile Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Home Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Other
YesNo
ADDITIONAL INFORMATION
Should be Empty: