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Child Dedication Request

Child's Full Name *

Child's Date of Birth *

Father's Full Name *

Mother's Full Name *

Parent Email *

Phone Number *

Home Address *

Are both parents members of Emmanuel Miami? *

Preferred Dedication Date

Godparents/Sponsors Names (if applicable)

We have completed the child dedication class *

We commit to raising our child in the Christian faith *

We give permission for photos/videos during the dedication