Baby Dedication

    Infant Information
    Name of infant*
    Age of infant*
    Gender*
    Approximate weight
    Your relation to infant*
    Your Information
    Your Name*
    Address*
    City*
    State*
    Zip*
    Phone 1*
    Phone 2*
    Email*
    Have you been born again?*
    Yes |No
    Are you a member of this church?*
    Yes |No