Baby Dedication Form CHILD'S FULL NAME * First Name Last Name Child's Date of Birth * MM DD YYYY Name of Birth Hospital * Gender * Male Female Requested Month of Dedication * (2nd & 4th Sabbaths) January February March April May June July August September October November December Alternate Month if not available * (2nd & 4th Sabbaths) January February March April May June July August September October November December Mother's Full Name * Father's Full Name * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Contact Phone Number * (###) ### #### Email * Is at least one parent a member of Kingsboro Temple? * This is not a condition for the baby dedication. Yes No GODPARENT'S INFORMATION Godmother's Full Name Godfather's Full Name Who will participate in the ceremony? * Both parents Mother only Father only Godparent(s) Thank you!
