Child Dedications

Child's Full Name *

Mother's Name *

Father's Name *

Parent Email *

Parent Phone Number *

Child's Age *

Colors of child's room (List 2-3) *

Choose the day you want your child dedicated: *

October 21st

Choose the preferred Sunday service: *

10:20

11:40

1pm

Upload a picture of your child that you would like to show on the screen (If you have trouble uploading, please e-mail one to lexfriar@gmail.com) *