Baby Dedication Application 

Date:
Parent's First and Last Names: *
Home Phone:
Cell Phone:*
Contact Email:*
Child's FULL Name:*
Child's Preferred Name:
Child's Date of Birth/Age: *
Child's Gender:*
Are there siblings that you will have standing with you:*
If YES, please print their names and ages: *
Date of Dedication: *
Will there be Grandparents attending:*
Will you have someone assigned to take pictures:*
Any other comments: