CHILD DEDICATION FORM

Please complete form two weeks prior to dedication.

Child dedications are scheduled on the second Sunday of each month (except when a special event prohibits) for children ages: Birth – 8 years old.

If you would like to have your child dedicated to the Lord, please complete the form.

Church office personnel will contact you to confirm your requested date.

Please complete all required fields.

CHILD'S INFORMATION

Child’s Name(Required)

First Middle Last Suffix

Child’s Date of Birth(Required)

Gender(Required)

Requested Month of Dedication(Required)

Parents Information

Mother's Full Name(Required)

First Last

Father’s Full Name(Required)

First Last Suffix

Which parent is a member of Strong Tower Ministries?

Contact Phone Number(Required)

Contact Email(Required)

GODPARENT'S INFORMATION

Godmother's Full Name