Dedication Registration

The next Children's Dedication will be Sunday, September 17th. Registrations are due by 4 pm on Wednesday, September 13th. There will be an orientation at 6:30 pm on Wednesday, September 13th.

Fathers First and Last Name:

Mother's First and Last Name

E-mail: *

Phone: *

Address: *

State: *

Zip code: *

Child's Full Name *

Child's Name *

First Name Middle Name Last Name

Child's Birthdate *

- Month - Day Year

Name of Prayer Partner(s) *

First Name Last Name

Prayer Partner Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Add Child

I'd like to have another child dedicated

Child's Full Name

Child's Name

First Name Middle Name Last Name

Child's Birthdate

- Month - Day Year

Name of Prayer Partner(s)

First Name Last Name

Prayer Partner Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Add Child

I'd like to have another child dedicated

Child's Name

First Name Middle Name Last Name

Child's Birthdate

- Month - Day Year

Name of Prayer Partner(s)

First Name Last Name

Prayer Partner Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Add Child

I'd like to have another child dedicated

Child's Name

First Name Middle Name Last Name

Child's Birthdate

- Month - Day Year

Name of Prayer Partner(s)

First Name Last Name

Prayer Partner Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Add Child

I'd like to have another child dedicated

Child's Name

First Name Middle Name Last Name

Child's Birthdate

- Month - Day Year

Name of Prayer Partner(s)

First Name Last Name

Prayer Partner Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Add Child

I'd like to have another child dedicated

Child's Name

First Name Middle Name Last Name

Child's Birthdate

- Month - Day Year

Name of Prayer Partner(s)

First Name Last Name

Prayer Partner Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Child Dedication Registration