Child Dedication Form
Name of Parent or Guardian
*
First Name
Last Name
Name of additional Parent or Guardian
First Name
Last Name
E-mail of Parent or Guardian
*
Below, Please only list the names of the child(ren) being dedicated
Child 1
*
First Name
Middle Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
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Child 2
First Name
Middle Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date Picker Icon
Child 3
First Name
Middle Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date Picker Icon
Child 4
First Name
Middle Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date Picker Icon
1st Desired Service Time for Child Dedication
*
9am
10:30am
Name of Prayer Partner
First Name
Last Name
Do you need a prayer partner?
Yes
No
Testimony
*
Family/Child Picture
*
Submit
Should be Empty: