Child Dedication
Event Date: Sunday, May 12th, 20198
Event Address: West Ridge Community Church. 3300 Encounter Lane. Elgin, IL 60124
Questions?Email jana@westridgechurch.net
Parent's Name(s) *
Address *
Phone Number *
Email Address *
Do you currently attend West Ridge? *
If yes, how long have you been attending?
If no, how did you hear about our Child Dedication?
Name of Child # 1 to be dedicated (Name as it will appear on the certificate)
Date of Birth of Child # 1 *
MM
/
DD
/
YYYY
Name of Child # 2 to be dedicated (Name as it will appear on the certificate)
Date of Birth of Child #2
MM
/
DD
/
YYYY
Name of Child # 3 to be dedicated (Name as it will appear on the certificate)
Date of Birth of Child # 3
MM
/
DD
/
YYYY
Preferred Service *
Photos or short video clips of Child #1 for Ceremony *
Required
Photos or short video clips of Child #2 for Ceremony
Photos or short video clips of Child #3 for Ceremony
Submit
Never submit passwords through Google Forms.
This form was created inside of West Ridge Community Church. - Terms of Service