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POLL
I am registering for the next Baby Dedication which will be held on the next 5
th
Sunday of the month.
Infants and Toddlers under 24 months may participate. If you would like your child dedicated, please complete this form. The church will contact you with the most current schedule.
To send us a message, enter your name and email address.
Child's Full Name:*
Gender:*
Boy
Girl
Father's Name:*
Mother's Name:*
Email:*
Location Preference:*
Midtown
East
Street Address:*
City:*
State:*
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Zip:*
Home Phone:*
Work Phone:*
Ext.
Other Phone:
Ext.
Who will stand with you (Grand Parent, God Parent) Please list below
Name:*
Relationship:*
Name:*
Relationship:*
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