baby/Child dedication

omar-lopez-vTknj2OxDVg-unsplash.jpg
 

Baby/Child DEDICATION interest form

 

Please complete the form below

Mother's Name *
Mother's Name
Father's Name *
Father's Name
Phone *
Phone
Child's Name *
Child's Name
Child's Gender *
Child's Date of Birth *
Child's Date of Birth
Dedication Certificate Mailing Address *
Dedication Certificate Mailing Address
Are you a regular attender of The Lighthouse Church? *