Braeswood Assembly of God

2020 Child Dedication Form January-December

Child Dedication Orientation

page 1 of 2

Father's Name


First Name	Last Name

Mother's Name


First Name	Last Name

Marital Status

Select one

Married
Single
Divorced

Child's Name


First Name	Last Name

Gender

Select all that apply

Male
Female

Address

Phone 1

Phone Number

Phone 2

Phone Number

Email 1

Email Address

Email 2

Email Address

Child Dedication Orientation Dates

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Child Dedication Orientation Dates

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Child Dedication Orientation Dates

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Child Dedication Ceremony Dates

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* required