BABY DEDICATION REQUEST - Coastline Calvary Chapel

CHILD'S FULL NAME *

CHILD'S DATE OF BIRTH *

MOTHER'S FULL NAME *

FATHER'S FULL NAME *

RELATIONSHIP TO THE CHILD

I AM THE CHILD'S... *

(relation)

I AM THE CHILD'S LEGAL PARENT/GUARDIAN *

DAYTIME PHONE *

DO YOU (THE CHILD'S FAMILY) ATTENDED COASTLINE? *

I AGREE WITH THE DOCTRINAL STATEMENT OF COASTLINE CALVARY CHAPEL *

YES, I AGREE

NO, I DO NOT AGREE

WHAT MINISTRIES AT COASTLINE ARE YOU INVOLVED IN? *

None

Worship/Production

Greeting

Housekeeping

Security

Kidz Ministry

Student Ministry

Serve Team

CoffeeHouse/SHOP

Event Support

Connect Groups

Prayer Teams

WHAT DATE WOULD YOU LIKE THE DEDICATION TO TAKE PLACE? *

(Subject to Approval. We will try to meet your request, but cannot guarantee it)

WHAT TIME (SERVICE TIME) WOULD YOU LIKE THE DEDICATION TO TAKE PLACE? *

HOW MANY PEOPLE WILL BE ACCOMPANYING THE CHILD FOR DEDICATION PRAYER? *

COMMENTS/OTHER PREFERENCES:

(Subject to approval. We will do our best to accommodate your preferences when appropriate)