Child Dedication Registration

Thank you for your interest in participating in a Child Dedication!
Please complete the registration information below and select a preparation class to attend.

If you have any questions before then, please contact Cortney Spotts.

*First Name

*Last Name

*Email Address

*Phone Number

*Address Line 1

Address Line 2

*City

*State/Province/Region

*Zip/Postal Code

*Which Blackhawk site/venue does your family usually attend?

*Which service time do you usually attend?

Class Dates:

*Child's First Name:

*Child's Middle Name:

*Child's Last Name:

*Child's Birth Date
(mm/dd/yyyy):

Parents' Names:

Street Address:

City:

State:

Zip Code:

Email Address:

Phone Number:

*Siblings:

no:

Submit Form