Child Dedication Request

Your name *

Last name

Email address *

Mother's name *

Father's name *

Phone Number

Phone type

MobileHomeWorkOther

Address

HomeWorkOther

Country

Country

Street address

Apt/unit/box (optional)

City

State

Postal code

Child's legal name *

Gender *

Select…MaleFemale

Birthday *

Pastor's name you'd like to dedicated your child *

Requested date of dedication *

*NOTE* Please select only the 2nd or 4th Sabbath

Submit

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