Victory Outreach Cape Town

Victory Outreach Cape Town
Baby Dedication Information Sheet

Please fill in the form below.
Parents Name Mom*

PrefixFirst NameSurname
Parents Name Dad*

PrefixFirst NameSurname
Baby's Name

First NameSurname
Age of Baby:
Date of Birth:
Address*

Street Address

Address

CityState / Province

Postal / Zip Code
Home Phone:

Area CodePhone Number
Cell Phone*

Area CodePhone Number
E-mail*
Do you attend Victory Outreach Cape Town?
If yes how long?
Where you referred by friend or family member?
If so, by who?
Are you married?
Only legally married couples will be allowed to stand on stage with the child. In the case of an unmarried parents; only the child's mother will stand on stage with the child.
Who will be on stage with the baby?
Note:

1. A maximum of 5 people are allowed on stage with the baby.

2. Someone will be in contact with you regarding the date of the dedication and of the class.
Please let us know if you have any questions or comments:
Should be Empty:

Baby Dedication Information Sheet