If you would like to have your child dedicated on December 1st, please sign up below!

Mother's Name *

Mother's Name

First Name

Last Name

Father's Name *

Father's Name

First Name

Last Name

Phone *

Phone

(###)

###

####

First, Middle, and Last name of child being dedicated *

Age of child being dedicated: *

First, Middle, and Last name of child being dedicated

Age of child being dedicated:

First, Middle, and Last name of child being dedicated

Age of child being dedicated:

Thank you!