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Child Dedication Interest Form
Please include the names and ages of each child to be dedicated on January 12, 2020 (typically 5 years old or younger). Once received, a staff member will contact you with more details.
Name of parents or legal guardian
Please provide the full name of child to be dedicated:
Gender of child
Please provide child's date of birth.
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This form was created inside of Vineyard of the Rockies.