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Please complete the form below to register for Baby Dedication Martinsville 11:00 AM.
Child's Information:
First Name
First Name is required.
Last Name
Last Name is required.
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Birthdate cannot be a future date.
Parent's Information:
Parent's First Name
Parent's First Name is required.
Parent's Last Name
Parent's Last Name is required.
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How would you like the child's name to appear on the certificate?
How would you like the child's name to appear on the certificate? is required.
How would you like the parent's names to appear on the certificate?
How would you like the parent's names to appear on the certificate? is required.
Will both parents be able to participate in the dedication event?
No
Yes
Will both parents be able to participate in the dedication event? is required.
Please tell us how you heard about this event:
Weekend Handout
Platform Announcement
Emmanuel App Notification
Informational Postcard
Social Media
Word of mouth
Other
Please tell us how you heard about this event: is required.
Complete Registration