Kids: Child Dedication Request

To begin the dedication process, please complete the following form. You will be contacted to set up a short interview with the Kids Pastor.

The child dedication will be held during both services.

Child(ren) to be Dedicated

Please list the child's name, birthday & gender. Also, list the best email for contact.

Multiple Children

Yes

No

First Name

Last Name

Birthdate

Gender

Child #2 to be Dedicated

First Name

Last Name

Birthdate

Gender

Child #3 to be Dedicated

First Name

Last Name

Birthdate

Gender

Child #4 to be Dedicated

First Name

Last Name

Birthdate

Gender

Child #5 to be Dedicated

First Name

Last Name

Birthdate

Gender

Other Information

Parent Information

First Name

Last Name

Email

Phone Number

Who will be present for the dedication?

Mother's Name

Father's Name

Preferred Sunday for Dedication

Preferred Service for Dedication