BABY DEDICATION REQUEST

Name of Parent 1

First Name

Last Name

Name of Parent 2

First Name

Last Name

Full Name of Child (First / Middle / Last / Suffix

Location of Birth - City and Hospital Name

Weight / Length of Child at Birth

Official Date / Time at Birth

Email Address

Statement of Faith

A short statement of faith from the parents and the importance of dedication. (if available)

Additional Comments

Please also send us an email with a picture of your child for us to post on the screen during the dedication.