Child Dedication Form

Child Dedication form and sign-up

Your name *

Last name

Email address *

Parent(s) Name

Phone number

Phone type

MobileHomeWorkOther

Address

HomeWorkOther

Country

Country

Street Address

Apt/unit/box (optional)

City

State

Postal code

Child's (Childrens) Full Given Name

Child's (Childrens) Date of Birth

Preferred service for Dedication *

Select…Sunday, November 23rd, 9:30 amSunday November 23rd, 11:15 amOther

Which class would you like to attend? *

Select…Sunday, November 9th, @9:30 am, Room 214Sunday, November 16th, @11:15 am, Room 214Other

Submit

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