EmailMe Form - Baby Dedication Confirmation Form

ATTENTION STAFF

Submitted By (Your Name) *

Submitted By (Your Email) *

Dedication Date *

MM / DD / YYYY

Service Time *

Please make sure that all the family's contact information is updated in Fellowship One when submitting this request.

Father's Name

First Last

Mother's Name

First Last

Parent's Phone

### - ### - ####

Parent's Email

Child's or Children's Name(s) *

Child's or Children's Age(s)

Gender *

Dedicating Pastor

If other, write in notes below.

Media Requested

DVD

Download Link

Have they paid $10 for Video Media?

Notes