Bethel Family Worship Center - Child Dedication Form

Child Dedication Form

Please complete the following information, which will be used to enable us to process your Child Dedication
Last Name (Child)	*
First Name (Child)	*
Child’s Date of Birth	*
Gender	*
Father’s Last Name (If applicable)
Father’s First Name (If applicable)
Mother’s Last Name (If applicable)
Mother’s First Name (If applicable)
Relationship to the child?	*
Street Address	*
City	*
State	*
Zip	*
Cell Phone
Do you attend Bethel Family Worship Center?	*
Who will be bringing the child forward during the dedication ceremony? (Please note: Only the parents/guardians will participate in the ceremony.)
Why do you desire child dedication? *
Have you and your spouse (if applicable) accepted Jesus Christ into your lives as your Savior? *
Your Email Address	*