Baby Dedication Request
To request a dedication for your newborn, please fill out form below.
Email address *
Child's information
Child's Last Name (Numele de familie al copilului) *
Your answer
Child's First Name (Prenumele copilului) *
Your answer
Child's Middle Name (Numele mijlociu al copilului)
Your answer
Birth Date (Data nașterii) *
MM
/
DD
/
YYYY
Gender (Gen) *
Is this your family’s first, second, third, etc child? (Al câtelea copil este în familie?) *
Parents information
Father's Name (Numele Tatălui) *
Your answer
Mother's Name (Numele Mamei) *
Your answer
Home Address (Adresa de acasă) *
Your answer
Are the child's parents members at Bethel Church? If no; which church are they members at? (Părinții copilului sunt membri ai Bisericii Bethel? Dacă nu, unde sunt membri?) *
Requested Dedication Date? (Data oficierii binecuvântării) *
MM
/
DD
/
YYYY
A copy of your responses will be emailed to the address you provided.
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