Parent Dedication Sign-up
Email address *
Registration Form
By filing out this form, you are registering to make a public commitment before a faith community to raise your child in a Christ centered home and to establish a spiritual foundation for your child to trust Jesus.
Child's Full Legal Name *
Please include first, middle, and last name of the child
Child's "Goes By" Name
Please enter the name your child "goes by" here if different from the answer given above.
Child's Birth Date *
MM
/
DD
/
YYYY
Father's Name *
First & Last name, please. (As you would like to be referred to during the dedication and on the certificates)
Mother's Name *
First & Last name, please. (As you would like to be referred to during the dedication and on the certificates)
Parent's Phone Number *
Please provide a phone number where you can be reached the morning of the dedication.
Siblings' Name(s) & Age(s)
Please list the names of the siblings that will be participating in the dedication.
Dedication Service Times *
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service