Antioch Baptist Church North Baby Dedication Intent

Antioch Baptist Church North Baby Dedication Intent

Please complete this form and a member of our New Arrivals Ministry will be in touch with you.
Mother's Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mother's Primary Contact Number*
Please enter a valid phone number.
Mother's Primary Email*

Confirmation Emailexample@example.com
Father's Name*

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Father's Primary Contact Number
Please enter a valid phone number.
Father's Email

Confirmation Emailexample@example.com
Maternal Grandparent Name

First NameLast Name
Paternal Grandparent Name

First NameLast Name
Godparent's Name
Sibling's Name (s)
Baby's Name*

First NameMiddle NameLast Name
Male or Female*

MaleFemale
Birth weight*
Length*
Date of Birth*

MonthDayYear
Date
Place of Birth*
Name of Hospital*
Are you a member of Antioch Baptist Church North?

YesNo
Upload a picture of your child that we can include in our program and/or special gift

Cancelof
All information on this form is required as the church office and The New Arrivals Ministry must be able to contact you to share important information regarding your baby's dedication. Your cooperation is greatly appreciated.
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