BABY DEDICATION REQUEST FORM

Are you a member or regular attender of Harvest Point?

Please select one option.

Yes No

CHILD’S INFORMATION

Baby/Child First and Last Name

Date of Birth

Gender

Please select all that apply.

Male Female

Requested Sunday of Dedication:

Second Option:

Optional

Service Time

Please select all that apply.

8:30 10:00 11:30

PARENTS INFORMATION

Father's Name

Mother's Name

Email

This address will receive a confirmation email

Phone

Address

GRANDPARENTS INFORMATION (OPTIONAL)

Maternal Grandmother’s Name

Maternal Grandfather’s Name

Paternal Grandmother’s Name

Paternal Grandfather’s Name

GODPARENTS INFORMATION

Godmother’s Name

Godfather’s Name

Who will participate in the Baby Dedication Ceremony?

Please select one option.

Both parents Mother only Father only Godparent(s) Option Grandparents

Please indicate those outside the list provided who will join you on the stage. (Please list with commas in between)

Baby Picture Upload

Upload (8MB)

Date Requesting to have Baby Dedication (Please note dates are subject to availability and should be no less than two weeks out and is subject to availability)

Description

BABY DEDICATION REQUEST FORM

Please Fix the Following

Close