Child Dedication

Your name *

Email address *

Phone number *

Can you tell us the full name of your child? *

What is your child's birth date? *

Can you tell us a bit more about your child? *

We'd love to get to know your little one a bit more... what are they like? What characteristics do they have? How do they fit into your family dynamic?

Why you are wanting your child to be dedicated? *

What are some of the hopes and dreams that you have for your child? *

Would you like anyone specific to share a thought or scripture during the dedication?

Please list at least two options for preferred Saturday dates for your child's dedication. *

Please share some photos of your little one that can be displayed during the dedication.

Ideally we will have around ten photos to display on the screen during your child's dedication. There is a maximum of five photos that can be attached to this form. Please also email some extra pictures to shae@gracegate.org.nz following your completion of this form.

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Is there anything specific you would like to ask us, or that you would like us to know?

A copy of your responses will be sent to your email address.