BABY DEDICATION SIGN-UP


BABY'S FULL NAME:       BABY'S GENDER:    MALE     FEMALE

DATE OF BIRTH:       AT WHICH HOSPITAL WERE THEY BORN? 

PARENT'S NAMES:    & 

ARE PARENTS MARRIED?     YES     NO          HOW LONG HAVE YOU ATTENDED WINSTONSALEMFIRST?       PARENT'S PHONE # 

E-MAIL ADDRESS: 

BABY'S LIFE VERSE (PLEASE LIMIT TO ONE OR TWO VERSES FROM ONE CHAPTER, AND INDICATE BIBLE TRANSLATION, EX. Ps. 1:1-2 NIV):


After we receive your dedication request, we will contact you regarding the next available date. 
If you have any questions, please contact Jini at 336.759.8007