Form Entry

We’re so glad you’re interested in participating in a Child Dedication Service at Living Word! This application lets us get to know your family and help you take this special step when the time is right. Please note that submitting the application doesn’t guarantee a spot in the service. Once we receive your application, our team will review it and follow up with you by email with confirmation or next steps.

First Name

Last Name

Mobile Phone

Address

Marital Status

Mother - Have you come to a place where you've committed your life to Christ?

No Yes

Mother - Have you been baptized?

No Yes

Mother - How would you describe your relationship with Christ?

Mother - How long have you attended Living Word?

Mother - Have you ever participated in a child dedication class at Living Word before?

Mother - Are you able to attend the mandatory class?

Would you like to dedicate your child at the 9:30 or 11:00 am service?

9:30 11:00

Father's First and Last Name

Father's Address (if different from mother's)

Father's Email Address

Father's Marital Status

Father - Have you come to a place where you've committed your life to Christ?

No Yes

Father - Have you been baptized?

No Yes

Father - How would you describe your relationship with Christ?

Father - How long have you attended Living Word?

Father - Have you ever participated in a child dedication class at Living Word before?

No Yes

Name of 1st child to be dedicated

1st Child's Gender

1st Child's Date of Birth

Name of 2nd child to be dedicated (If applicable)

2nd Child's Gender

2nd Child's Date of Birth

Name of 3rd child to be dedicated (If applicable)

3rd Child's Gender

3rd Child's Date of Birth

Siblings

Submit

Child Dedication Application

Form Entry