Parent + Child Dedication Registration

Parent + Child Dedication Registration
Join us on Sunday, May 10th during our 10:00 AM Worship Service for a special time as parents dedicate their child to the Lord.

Please complete this registration by April 26th.
Parent/Guardian Name #1*

First NameLast Name
Parent/Guardian Name #2

First NameLast Name
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
YesNo
Child’s Full Name*
Child’s Date of Birth*

MonthDayYear
Date
MaleFemale
Names of siblings attending
Any additional information we need to know?
Should be Empty: