Child Dedication Application Form

Complete this Form and we will contact you to confirm arrangements and provide date options.

Full Name of Child who will be dedicated *

Date of Birth of Child who will be dedicated *

Mother's First Name *

Mother's Last Name *

Mother's Mobile Number *

Mother's Email Address *

Father's First Name

Father's Last Name

Father's Mobile Number

Father's Email Address

Do you attend Berwick Church of Christ? *

Yes

Please ensure you upload a photo of the baby or child being dedicated, which will be displayed on a powerpoint in the service during the dedication.

We will be in contact with you during the week.