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Baby Dedications-Anna on Sunday, December 1, 2019 @ 10:00 AM

*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:

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