Christian Cultural Center
Queue - Baby Dedication 2016
Grace and Peace! PARENTS, please use this form to pre-register your baby or young child to be dedicated to the Lord. You will receive a confirmation email once registration is completed. Thank you!
PLEASE NOTE: This form is to be completed ONLY BY THE PARENT OR LEGAL GUARDIAN OF THE CHILD INTENDED TO BE DEDICATED.
If you are NOT the PARENT or LEGAL GUARDIAN, please DO NOT use this form. THANK YOU for your cooperation!
Please choose your relationship to the child:
PLEASE CHOOSE from drop down menu:
Please enter your Baby's name below. Please be mindful to SPELL CAREFULLY, as this is how the child's name will appear on the certificate.
Baby's FIRST Name
Baby's MIDDLE Name
Baby’s LAST Name
Baby’s Date of Birth:
Your First Name
Your Last Name
Is this your home or cell/mobile phone number?
Cell / Mobile
Your Email Address
Are you registering more than one child IN THE SAME HOUSEHOLD to be dedicated?
2nd Baby's FIRST Name
2nd Baby's Middle Name
2nd Baby's Last Name
2nd Baby's Date of Birth
2nd Baby's Gender
Please Choose from drop down menu:
Dedications are held on the 3rd Sunday of each month during the 10AM and 12PM services. Please choose the MONTH you would like to attend:
Please choose the service time you would like to attend:
Are you a CCC Member?
Which CCC Campus location do you desire to have your baby dedicated?
Long Island Campus (CCCLI)
Thank You for pre-registering your baby or young child for dedication unto the Lord. You will receive a confirmation email once registration is completed. You will also be emailed a LINK to your form submission as a RECEIPT which will EXPIRE in 30 days. Please make a copy for your records. BLESSINGS! Please leave any comments to the right ===>>>>
++++++++++ FOR STAFF USE ONLY ++++++++++
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