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Child Dedication Application Beaver Valley

If you are interested in having your child dedicated, please take time to fill out the following form. When finished, click the submit button.


*Child's First Name:
*Child's Middle Name:
*Child's Last Name:
*Child's Date of Birth:
*Child's Gender:
Second Child's Full Name:
Second Child's Date of Birth:
Second Child's Gender:
*Mother's Full Name:
*Father's Full Name:
*Email Address:
*Phone Number:
*Marital Status:
*I regularly attend North Way Christian Community:
I wish to have my child dedicated on:
Number of guests attending:
Please write a blessing to read to your child on the day of the Child Dedications. Examples can be found here (www.northway.org/child-dedications). Please use 75 words maximum.
*Blessing:

Before completing the application, please send in a photo of your child to be used during the Child Dedication Celebration to Robinh@northway.org

Photography Release Statement

By registering my child(ren), I give North Way Christian Community permission to publish or reproduce photographs or video images of my child(ren) for presentations and/or promotional purposes (print, website, social media, future advertising, etc.) and waive any rights of compensation or ownership.
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