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CHILD DEDICATION
Your name
*
Last name
Email address
*
Phone number
*
Phone type
Mobile
Home
Work
Other
Desired Dedication Date (choose one)
*
August 8th - Saturday 5:00pm Service
August 9th- Sunday 11:45am Service
Other Parent's Name
*
Child's Name
*
Birthdate
Date
Child's Name
Birthdate
Date
Child's Name
Birthdate
Date
If the parents are not married, are they living together?
*
Yes
No
Married
Please check all that apply
*
At least one parent serves on the Reach Team
At least one parent has completed our Crosswalk Classes
I need more information about joining the Reach Team or taking Crosswalk Classes
I have read the requirements for Child Dedication and comply with these requirements.
*
crosschurchhouma.com/childdedication
Yes
No
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