MGBC Child Dedication Fall 2018
Baby/Child Full Name *
Date of Birth *
MM
/
DD
/
YYYY
Father's Name *
Paternal Grandparents Names
Mother's Name *
Maternal Grandparents Names
How many children do you have? *
How many family and friends OVER the age of 10 will be attending the luncheon? *
How many family and friends UNDER the age of 10 will be attending the luncheon? *
Email Address *
Phone Number *
Please upload a picture of your child to be shown during our service. *
Required
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