Child Dedication Form

Father's first and last name

Mother's first and last name

Phone number of primary contact

Email of primary contact

Name of 1st Child (As it will appear on the certificate)

Child's Birthdate

Name of 2nd Child (As it will appear on the certificate)

Child's Birthdate

Name of 3rd Child (As it will appear on the certificate)

Child's Birthdate

*Please email a clear photo of your child or children to info@ilifehouse.org to be displayed during the dedication.

Success! This form has been submitted.