Child Dedication Form

CHILD DEDICATION FORM We look forward to helping you dedicate your child to God. Please share the information below so we can schedule your child’s special day.

Parent(s)/Guardian(s) Full Name(s) *Please enter the full names as you would like them to appear on the certificate.

Enter one ore two phone numbers for the Parent(s)/Guardian(s) *Enter at least one phone number.

Enter one or two emails for the Parent(s)/Guardian(s) *Enter at least one email.

Name(s), gender(s), and birthdate(s) of child(ren) to be dedicated: *

Requested dedication date (first choice): *Select the date.

Requested dedication date (second choice): *Select the date.

Preferred service time: *

09:30 AM

12:00 PM

No Preference

Which pastor you would like to officiate the dedication?

Anything else you would like us to know?

Child Dedication Form

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