Baby/Child Dedication Form

Baby/Child Dedication Form
Today's Date

MonthDayYear
Baby/Child's Name:*

First NameMiddle NameLast Name
Gender of Child*
For every baby dedication, we inscribe the first, middle, and last name of the child on a New Testament Bible. Sometimes the child's name is too long because of the middle name, if this is the case what would you prefer?
Inscription options if name is too long.

Use first and last name. (i.e. George Washington)Use first name, middle initial and last name. (i.e. George A. Washington)Use first name only. (i.e. George)
What color of New Testament would you prefer?

PinkWhiteBlue
Child's Birthdate:*

MonthDayYear
Place of Birth:*

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Mother's Name*

First NameLast Name
Father's Name*

First NameLast Name
Email*
example@example.com
Mobile Number*
Please note, how you spell your child's name above will be how it appears on the Dedication Certificate and New Testament Bible, please double check your spelling and the birthdate.
Should be Empty: