Child Dedication Request Form
Our next Child Dedication Sunday is July 15th. Parents who have children ages infant - 3 y.o. must attend the Child Dedication Class scheduled for Thursday, June 21 @ 6:30pm. Upon the receipt of this completed form a CBC staff person will contact you to confirm your class registration.
Your Information
Name - First/Last *
Your answer
Email *
Your answer
Phone # *
Your answer
Alt. Phone #
Your answer
Address, City, State, Zip *
Your answer
Are you a member of CBC? *
Are their any special circumstances involved with the dedication of your child(ren)?
Your answer
Child(ren's) Information
1 - Child's Full Name *
Your answer
1 - Child's Date of Birth *
Your answer
2 - Child's Full Name
Your answer
2 - Child's Date of Birth
Your answer
3 - Child's Full Name
Your answer
3 - Child's Date of Birth
Your answer
4 - Child's Full Name
Your answer
4 - Child's Date of Birth
Your answer
Do you have a Pastor in mind for your dedication?
Please note: We will do our best to accommodate your request, but there is no guarantee of the availability of the requested Pastor.
Your answer
Have you already contacted the Pastor?
Comments or Questions?
Your answer
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