LZBC 2024 BABY DEDICATION FORM
Please complete this form by Sunday, November 3, 2024
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CHILD'S INFORMATION
Child's Full Name
First Name
Middle Name
Last Name
Child's Birth Date
/
Month
/
Day
Year
Date
Upload an image of your child
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PARENT/GUARDIAN & GRANDPARENTS INFORMATION
ARE YOU A MEMBER OF LITTLE ZION BAPTIST CHURCH?
Please Select
YES
NO
IF NO, ARE YOU A MEMBER OF ANOTHER CHURCH?
Please Select
YES
NO
IF YES, PLEASE TYPE IN THE NAME OF YOUR CHURCH
YOUR CHURCH ADDRESS
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
WHO IS PRESENTING THE CHILD?
Please Select
Father & Mother
Mother ONLY
Father ONLY
Paternal Grandmother & Paternal Grandfather
Maternal Grandmother & Maternal Grandfather
Paternal Grandmother ONLY
Paternal Grandfather ONLY
Maternal Grandmother ONLY
Maternal Grandfather ONLY
Guardian
FATHER
First Name
Middle Name
Last Name
Suffix
MOTHER
First Name
Middle Name
Last Name
PATERNAL GRANDFATHER
First Name
Middle Name
Last Name
Suffix
PATERNAL GRANDMOTHER
First Name
Middle Name
Last Name
MATERNAL GRANDFATHER
First Name
Middle Name
Last Name
Suffix
MATERNAL GRANDMOTHER
First Name
Last Name
Your Mailing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Your Phone Number
-
Area Code
Phone Number
Your Email Address
example@example.com
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GOD-PARENT'S INFORMATION
GODFATHER NAME
First Name
Middle Name
Last Name
PHONE NUMBER
GODMOTHER ADDRESS
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
GODMOTHER NAME
First Name
Middle Name
Last Name
PHONE NUMBER
GODFATHER ADDRESS (If same as above, skip)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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