Infant Baptism and Dedication Registration Form
Please complete one form for each child being dedicated or baptized. We must receive this information before we can confirm your participation.
Today's Date
Your answer
Child's Full Name *
Your answer
Date of Birth *
Your answer
I Would Prefer to Have My Child: *
Which Crossroads site do you attend? *
Parents'/Guardians' Names *
Your answer
Street Address *
Your answer
City, state and zip code *
Your answer
Phone Number *
Your answer
Parent's Email *
Your answer
Family Story
Please write a paragraph or two describing your family's story; how long you've been at Crossroads, how and when you decided to follow Christ, any special circumstances surrounding the birth of your child, etc.
Any Significant Meaning to Child's Name
Your answer
Story *
Your answer
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