RCCG City of David Atlanta Church, Georgia, North America

Baby Dedication Request Form

Parents Information

Name of Father*

Name of Mother*

Father's Phone Number( ) -

Mother's Phone Number( ) -

Email*

Address*

How often do the parents attend City of David, Atlanta?*

When did you join City of David Atlanta ?*

Contact person in City of David

If non-member please state the name of your contact person at City of David

Who will participate in the Baby dedication?*

Baby's Information

Name of Baby*

Baby's Other Given Names

Separate names by a comma.

Date of Birth*

Gender*

Male

Female

Place of Birth

Hospital Name, City and State

Requested Date of Dedication*

Baby's Picture*

Baby's Picture

Parents' Photo*

Photo of Parent(s)

Please leave this field blank.