Next Child Dedication service on Mother's Day May 11, 2025
Parent Information
Mother’s First Name
*
Father's First Name
Mother’s Last Name
*
Father's Last Name
Childs Information
Name of child to be dedicated (First, Middle, Last)
Birth Date (month, day, year)
Name of child to be dedicated (First, Middle, Last)
Birth Date (month, day, year)
Name of child to be dedicated (First, Middle, Last)
Birth Date (month, day, year)
If more children are being dedicated please list their names and birthdays here
Contact Information
Contact Phone Number
*
Contact Email Address
Mailing Address
Mailing Address Line 2
Mailing City
Mailing State
Mailing Zip Code
Submit
