Baby Dedication Interest Form

Please fill out the following baby dedication application.
Baby Dedication is reserved for children 0-24 months.

Parent's Names*

Home Phone*


Years Married

Mom - Daytime Phone*

Dad - Daytime Phone*

Baby's Name*

Date of Birth*

Name of Hospital*

Birth Weight*

Birth Length*

Birth Time*


Any Brothers or Sisters? (Names & Ages)

Please note any special circumstances regarding your baby

Email Address*

You will be contacted by the church office regarding scheduling of date and service. 

*Required


Enter the numbers as they
are shown in the image above