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Baby Dedications-During All Services on Sunday, September 15, 2019 @ 9:30 AM

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*I verify that the above "Attendee's Name" is the Child's full legal name:
*Child's Gender:
*Child's Birthdate:
*Birth Hospital Name:
*Birth City and State:
*Father's Full Name:
*Mother's Full Name:
*Whose cell number was entered above?:
*Whose email was entered above?:
*Alternate Phone Number - Please indicate whose it is:
*What is your preferred service time?
(These are assigned on a first response basis and times are not guaranteed)

Please review this Photo/Video Release Form
By registering online, you understand and agree to the terms.

*Photo/Video Release:
Anything else we need to know?: