EmailMe Form - SBCC Baby / Child Dedication Form

Parents Name *

Phone *

### - ### - ####

Parent/Guardian Email *

Address *

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

Name of Person/s that will be dedicated

If you need to add any additional names, please add them in the comment box below

Name #1 *

Birthdate #1 *

Name #2

Birthdate #2

Name #3

Birthdate #3

Comment(s)

*

	Yes	No
Are You a Member of SBCC?

If you are not a member of SBCC, you are required to meet with a pastor before the dedication ceremony. Someone will contact you to make an appointment.

Date Time

MM / DD / YYYY