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Child Dedication Registration - Sewickley 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.
If you have any questions about this process, please feel free to email Michelle Vits at michellev@northway.org.

*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:
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 michellev@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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