Baby Dedication Request

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Please use the form below to register your child for baby dedication.

Prefer to fill out a physical form? Download the request form below.

Baby Dedication Request Form

1 file(s) 182.65 KB

Download

Baby Dedication Request

Child's Full Name

Requested Dedication Date

Child's Date of Birth

Child's Gender MaleFemale

Mother's Name

Father's Name

Mother's Phone #

Father's Phone #

Home Phone Number

Email Address

Home Address Please include City, Zip Code, and State

Are One Or both Parents Born Again Christians? YesNoStill ConsideringUnsure what this means

Are You A Member of Hurley Baptist Church? YesNo

Are You A Member of New Hope Missionary Baptist Church? YesNo

Maternal Grandmother's Name

Maternal Grandfather's Name

Paternal Grandmother's Name

Paternal Grandfather's Name

Siblings' Names n/a if only child

Who Will Participate In The Baby Dedication Ceremony? Both ParentsMother OnlyFather OnlyMaternal GrandparentsPaternal GrandparentsGodparentsSelect everyone who will be present

Godmother's Full Name

Godfather's Full Name

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