CIAG Baby Dedication Form

Your name *

Email address *

Child's Information

Child's Full Name *

Gender *

Male

Female

Child's Birthdate *

Meaning of Child's Name (Optional)

Mother's Name *

Phone number *

Father's Name *

Phone number *

Is the mother a follower of Christ? *

Is the father a follower of Christ? *

Are the mother and father of the child married to each other? *

Is CIAG their church home? *

Photo of the Child

If possible, could you please attach a photo of the child so it can be shown on the screen?

No files currently selected

Add up to 5 files. Maximum file size 10 MB.

Date 1 (most preferred): *

Date 2: *

Date 3: *

Which service do you normally attend? *

Please provide any additional information you think we should know.

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