Child Dedication May 12th 2024
Please fill out this form and click submit.
Child's Full Name (to be printed on certificate)
*
Father's First and Last Name
*
Mother's First and Last Name
*
Child's Date of Birth
*
Email
*
This address will receive a confirmation email
Phone
*
Service Preference
*
Please select all that apply.
10am
11:30am
Submit
Description
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Please Fix the Following