Child Dedication Form

Child Dedication Form
Do you attend online or in person?

In Person Online
Child's Information
Full Name *

First Name Middle Name Last Name
Birth Date *

Month Day Year
Gender *

Female Male
Parent's Information
Marital Status *

Single Married Widowed Divorced
Mother's Name *

First Name Last Name
Mother's Mobile Phone *
Mother's E-mail *
example@example.com
Father's Name *

First Name Last Name
Father's Mobile Phone
Father's E-mail
example@example.com
Address *

Street Address Apt. #
City, State *

City State / Province
Zip Code *
Have you accepted Jesus Christ as your Personal Savior? *

Yes No
Have you been baptized? *

Yes No
How long have you been attending LTF? *
Should be Empty: