BABY DEDICATION FORM Congratulations on your desire to dedicate your child to the Lord! Ebenezer is eager to assist your family in this very important occasion. Kindly complete and submit the required information (one request/form per child). Please be advised that your requested Child Dedication date is not confirmed until you have received confirmation from our church clerk. Date Being Requested (First Preference) DD MM YYYY Date Being Requested (Second Preference) DD MM YYYY CHILD’S INFORMATION Child's Name First Last Sex Male Female Middle Name (Other Names) Date of Birth DD MM YYYY Place of Birth (Provide Hospital Name, City and State /Country) BIRTH ENTRY/CERTIFICATE NUMBER PARENTS' INFORMATION Mother's Name First Last Father's Name First Last Address Contact Number Email Address Are one or both parents members of Ebenezer SDA Church? Yes No If not, please state church affiliation : Who will participate in the Child Dedication Ceremony? Both Parents Mother Only Father Only Other (Please specify below) Tell us who will take part in the Child Dedicatory Ceremony Declaration I declare that a ll the information provided is accurate to the best of my knowledge , and agree to have my child/ward dedicated to the Lord on the appointed date. If you're not a fish leave this field blank: Click HereTo Download Form
