RCC Baby Dedication Application
After receiving your application form, the office will contact you to set up a meeting with one of our pastors. We will do our best to accommodate your time and location preference after your application has been approved, however scheduling is done on a first-come, first-served basis.
Email address
Today's Date
MM
/
DD
/
YYYY
Child's Full Name
Your answer
Date of Birth
MM
/
DD
/
YYYY
Place of Birth
Your answer
Mother's Name
Your answer
Father's Name
Your answer
Address
Your answer
Marital Status
Home Phone
Your answer
Cell Phone
Your answer
Names/Ages of other children
Your answer
I/we have met personally with the pastor
*If NO, then we will contact you to arrange a meeting prior to scheduling your child's dedication.
I/we have been attending Riverside since
MM
/
DD
/
YYYY
We prefer our child to be dedicated at the
A copy of your responses will be emailed to the address you provided.
Please complete the captcha before submitting the form.
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