Baby Dedication

Baby Dedication Information

Please complete the form below.
Child’s Name*

First NameMiddle NameLast Name
Mother’s Name*

First NameMiddle NameLast Name
Father’s Name*

First NameMiddle NameLast Name
Name(s) of sibling(s) of child:
Child’s Birth Date*

MonthDayYear
Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent’s Email Address*
example@example.com
Parent’s Phone Number*
Questions/Comments
Which date would you like to dedicate your child?*

March 23, 2025June 22, 2025September 28, 2025December 28, 2025
Should be Empty:

Baby Dedication Information