Child Dedication Registration

Please fill out the form below to register for our upcoming Child Dedication (takes place twice yearly in the fall and spring).

Mother's Name (required)

Father's Name (required)

Contact Email (required)

Contact Phone Number (required)

Which Celebration would you like your child(ren) to be dedicated at? (required)
 9:29 am 11:11 am No Preference

What is your child's name (please include middle name) and date of birth? (required)

Place of Birth (required for certificate)

Gender (required):
 Male Female

2nd child's name and date of birth?

Place of Birth

Gender:
 Male Female

3rd child's name and date of birth? (required)

Gender:
 Male Female

Place of Birth

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