Baby Dedication Application

Marital Status

Spouse Name (if applicable)

Email

Address

Campus

Home

Mobile

Your name(s) and your child(ren)'s names as you want them to appear on your certificate. **Please indicate the ages of your children being dedicated

How many will be attending? (Include guests and yourself)

Did you listen to all 3 audio files

Yes No

Please list any questions you may have here.

Registrant