Ada Bible Church: Child Dedication Registration

Child Dedication Registration Form

This is a special service designed to give parents the opportunity to publicly commit to raising their child in the way of Jesus.

This form registers you for the Child Dedication but your spot in the service is not secured until you attend an informational meeting. You will receive confirmation via e-mail at a later date regarding the service you have requested.

NOTE: If you do not see the confirmation page your form was not submitted properly. Please try again.

Please print names as you would like them to appear on the child dedication certificate.

Application Information

Fathers's First & Last Name	Mothers's First & Last Name
Street Address City State Zip
Telephone	Email

Child Information

Child's Full Name This will print on the dedication certiticate.	Childs's Gender Male Female
Childs's Date of Birth

Dedication Information How many people (including yourselves) do you expect to attend the service? (limit 16) How long have you been attending Ada Bible Church and how did you begin attending? Please choose from the following dates the day that works best for your request Sun Feb 8 2009 Sun May 3 2009 Sun Jun 21 2009