Child Dedication Gilroy

1
Marital Status* This field is required.
Married
Single
2
Participating Parent's Information* This field is required.
Mother's Full Name
Father's Full Name
Mailing Street Address including city and zip code
Email
Phone
3
Participating Parent Information* This field is required.
Parent's Full Name
Mailing Street Address including city and zip code
Email
Phone
4
Child's Information* This field is required.
Child's Full Name (First, Middle, Last)
Please Select
Please Select
Female
Male
Gender
Please Select
Please Select
Newborn (ages 0–5 weeks)
Infant (ages 5 weeks – 1 year)
Toddler (ages 1–3 years)
Preschooler (ages 3–5 years)
Age
DOB (ex: 11/11/2011)
5
Have you attended the Child Dedication Class before?* This field is required.
YESNO
6
The Dedication Class is on October 5th @ 6:00PM | Jr High Room* This field is required.Please provide the number of adults who will be attending.
1
2
Not able to attend
7
Use the following link to the online Dedication Class. If you are not able to attend the "In-Person" class, please use the link below to view the online video before the Dedication Service.

https://youtu.be/UWQjnz399vc
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