Congratulations on your desire to dedicate your child to the Lord! Our church is eager to assist you in this important matter.

Once your application is received in the office, the church Secretary will call you to confirm receipt of your application.

During the morning worship service, an area will be reserved for each family having a baby dedicated. At the appropriate time in the worship service, Apostle Lyons will invite parents, grandparents, godparents and the child being dedicated to come to the front of the sanctuary to begin the Baby Dedication Ceremony. At the conclusion of the ceremony, a Certificate of Dedication will be provided to the parents.


Child’s Information

Child’s Full Name*

Gender*

Date of Birth (mm/dd/yyyy)*

Hospital where child was born*

Requested Month of Dedication (First Choice)*

Requested Month of Dedication (Second Choice)*


Parent’s Information

Mother’s Full Name*

Father’s Full Name*

Full Address (Please include City, State and Zip)*

Home Phone (###-###-####)*

Mother's Work Phone (###-###-####)

Mother's Cell Phone (###-###-####)

Father's Work Phone (###-###-####)

Father's Cell Phone (###-###-####)

Email Address*

Are one or both parents born again Christians?*

Are one or both parents members of New Life Fellowship?*

Due to the spiritual nature of the questions asked during the Baby Dedication Ceremony, it is helpful for the Pastor to understand the marital and living situation of both parents. Which of the following best describes the parents’ marital and living situation?*

If Other Please Explain


Godparents’s Information

Godmother's Name

Godfather's Name

Who will participate in the Baby Dedication Ceremony? (Check All That Apply)
MotherFatherGodparent(s)

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