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Work Entry
Please complete the form below to register for Baby Dedication Garfield Park 9:00am.
Child's Information:
First Name
Last Name
Birthdate
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
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1911
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1907
1906
1905
1904
1903
1902
1901
1900
Parent's Information:
Parent's First Name
Parent's Last Name
Home Phone
Mobile Phone
Email
Address
Countries
United States
------------------------
Vatican
French Polynesia
Venezuela
Bermuda
Vietnam
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Curacao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Netherlands Antilles
Monaco
Thailand
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Ivory Coast
French Southern Territories
Finland
Egypt
Faroe Islands
Uganda
South Africa
South Korea
Norfolk Island
Jersey
Chad
Japan
Sierra Leone
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
U.S. Virgin Islands
Togo
Nauru
Macao
Gibraltar
Ukraine
Barbados
Croatia
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Reunion
Madagascar
Malawi
Malaysia
Maldives
FX
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Sweden
Lithuania
Saint Kitts and Nevis
Saint Lucia
Moldova
Senegal
Oman
Nepal
Bolivia
Central African Republic
Latvia
Svalbard and Jan Mayen
Myanmar
Namibia
Saint Helena
Northern Mariana Islands
Norway
Lebanon
France
Serbia
Serbia and Montenegro
Seychelles
Bahamas
Guyana
Guernsey
Guinea
Mayotte
Mexico
Georgia
Gambia
Comoros
Belgium
Germany
Aruba
Cocos Islands
Colombia
Botswana
Iran
Ireland
Isle of Man
India
Chile
Iceland
Vanuatu
Pakistan
Palau
Costa Rica
United States
Canada
Switzerland
Syria
Palestinian Territory
South Georgia and the South Sandwich Islands
Benin
Nicaragua
Armenia
Cape Verde
Bonaire, Saint Eustatius and Saba
Burkina Faso
Singapore
Sint Maarten
Slovakia
Luxembourg
Haiti
Heard Island and McDonald Islands
Tunisia
Micronesia
Cameroon
Austria
Grenada
Bahrain
Greece
Guadeloupe
Taiwan
United Kingdom
United States Minor Outlying Islands
Uruguay
Uzbekistan
Slovenia
Israel
Italy
American Samoa
Kenya
Guinea-Bissau
Guam
Somalia
New Caledonia
Fiji
Nigeria
Bosnia and Herzegovina
Tokelau
Sao Tome and Principe
Christmas Island
Niue
Macedonia
United Arab Emirates
Falkland Islands
Belarus
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Tonga
Jamaica
New Zealand
Lesotho
Liberia
Libya
Liechtenstein
Brazil
British Indian Ocean Territory
British Virgin Islands
Brunei
Bulgaria
Cuba
Bangladesh
Romania
Belize
Ghana
Azerbaijan
Tanzania
Tajikistan
Afghanistan
Burundi
Bouvet Island
Australia
Russia
Cook Islands
China
Hungary
Cayman Islands
Cambodia
Swaziland
North Korea
Albania
Solomon Islands
French Guiana
Algeria
YU
ZR
Aland Islands
Kiribati
Kosovo
Kuwait
Kyrgyzstan
Laos
Greenland
Niger
Honduras
Hong Kong
Trinidad and Tobago
Panama
Gabon
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Saint Barthelemy
Rwanda
Iraq
Indonesia
Andorra
Bhutan
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Saudi Arabia
Netherlands
Guatemala
Kazakhstan
Jordan
AL
AK
AS
AZ
AR
CA
CO
CT
DE
DC
FM
FL
GA
GU
HI
ID
IL
IN
IA
KS
KY
LA
ME
MH
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
MP
OH
OK
OR
PW
PA
PR
RI
SC
SD
TN
TX
UT
VT
VI
VA
WA
WV
WI
WY
How would you like the child's name to appear on the certificate?
How would you like the parent's names to appear on the certificate?
Will both parents be able to participate in the dedication event?
No
Yes
Please tell us how you heard about this event:
Weekend Handout
Platform Announcement
Emmanuel App Notification
Informational Postcard
Social Media
Word of mouth
Other
Complete Registration