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Child Dedication Form
Please fill out the form to register for a Child Dedication. If you have any questions, please contact Pastor Andrea at 601-678-6610 or email at
[email protected]
.
Mom's Name
Dad's Name
Email
Phone Number
Child's Full Name (First Middle Last)
Child's Birthday (mm/dd/yyyy)
Special Verse you would like displayed
Anything you would like us to know about your story:
Submit
