Baby Dedication Request

Please send us your request to have your baby dedicated at the University Heights Seventh-day Adventist Church.

Baby Dedication Request Form

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Name of Mother

First Last

Name of Father

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone Number*

Name of the Baby*

First Last

Date of Birth*

Place of birth (address, city,state, zip)

Name of Hospital

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