Baby Dedication Application
Please fill out this form and click submit.
Parent's Names
*
Address
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AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Phone
*
Email
This address will receive a confirmation email
Child's name (as you want it on the certificate)
*
date of birth
*
Have you accepted Jesus Christ as your Lord and Savior?
*
Please select one option.
yes
no
Do you recognize that your child is a gift from God?
*
Please select one option.
yes
no
Do you recognize that you need God's help in raising your child?
*
Please select one option.
yes
no
Is it your desire to dedicate yourself to raising your child in the ways of the Lord through prayer, teaching them the Bible, and encouraging their faith in Christ?
*
Please select one option.
yes
no
Submit
Description
Please fill out this form and click submit.
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