EmailMeForm
Baby Dedication Request Form
Please complete this form to request a Baby Dedication.
Family Name:
Father's First Name:
Mother's First Name:
Date of Marriage:
MM
/
DD
/
YYYY
Child's Complete Name:
Multiple Choice
Male
Female
Child's Date of Birth:
MM
/
DD
/
YYYY
Child's Place of Birth:
Siblings:
God Parents:
Address
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Phone Number:
###
-
###
-
####
Email Address:
Date of Dedication:
June 2022
Request Other Date
Requested Date of Dedication:
MM
/
DD
/
YYYY
*Not Guaranteed
Requested Service for Dedication:
9am
11am
*Not Guaranteed
Please upload a photo of the child being dedicated
*
