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* 1. Parent Information:

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* 2. Child's name: 

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* 3. Child's Date of Birth

Enter date here

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* 4. Campus (Choose One)

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* 5. Indicate service you usually attend, then provide three potential Sundays for the dedication in order of preference

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* 6. First Choice Date:

Date 1

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* 7. Second Choice Date: 

Date 2

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* 8. Third Choice Date:

Date 3

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* 9. Comments or requests: 

0 of 9 answered
 

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