May 4 & 5, 2019

Please complete the form below to register for our next Child Dedication.


Parent/Guardian Name(s) *
Parent/Guardian Name(s)
Child/Children Name(s) *
Child/Children Name(s)
Address
Address
Phone
Phone
McLane Church Site *
Service Time *
Photo/Video Release *
Please check your preference regarding the use of images and/or videos taken of your child(ren) at McLane Church:
As the parent/legal guardian of your child(ren), please electronically sign this form with your FULL NAME by typing it in ALL CAPS.