Child Dedication Application

Prior to setting a date for the dedication, you will be asked to meet with a pastor on staff regarding your application form and the details of the dedication. Fifteen minutes before the service on the day of the dedication, please check in with the Pastor who will be dedicating your child. It is our desire at Hillcrest Church for the parents of each child being dedicated to the Lord to have a Biblical understanding of what "Child Dedication" signifies. With this as our goal, we would like you to help us by answering a few brief questions that will be used to assist in preparing you and your child for dedication.

Family Information

Mother's Name:

Father's Name:

Marital Status:

Single* Married Separated* Divorced* Widowed

*Children of unwed parents will be dedicated by a single parent (either the mother or the father, not both) with the desire to dedicate him or herself to living and modeling a Christ-honoring lifestyle.

Address

Phone

Please briefly explain your relationship with Christ below...

Mother:

Father:

How long have you attended Hillcrest Church?

Do you attend regularly?

Yes No

What does having your baby dedicated mean to you?

Child's Information

Name of child to be dedicated: (First, Middle, Last)

Birthdate

Gender

Male Female

Siblings (Please list the names and ages of the infants siblings.)

Baby Dedication Date Requested

Please note that it is possible that more than one child will be dedicated per service.

Is there a date you prefer for the Dedication if it is available?

Is there a pastor you prefer to dedicate your child if they're available?

Is this your first child dedication at Hillcrest Church?

Yes No

Attending Family & Friends

We encourage you to bring your family and friends to the dedication service. Please give us an idea of whom you expect will attend that we could acknowledge as present with you today.

Please state their names and your relationship to them.

Verse or passage you have chosen to read for your child: (This can be discussed when you meet with a pastor. We do have passages you can choose from if you'd like.)

Commitment to Dedicate

1. I recognize that my child is a gift from God.
2. I promise to do whatever I can to model in front of my child what it means to be a fully devoted follower of Jesus Christ.
3. From this point forward, I promise to do whatever is necessary to make sure that my child has every exposure to the influence of other followers of Jesus, teaching that supplements my teaching, and opportunity to participate regularly in worship from now until the day this child is no longer in our home.
4. I understand that the congregation of Hillcrest Church has made the commitment to my family to help and support us in the raising of our children.

Father's Consent

Yes No N/A

Mother's Consent

Yes No N/A

Thank you for allowing us to share in the spiritual growth of your child. We trust that this dedication will be the beginning of a commitment by you and the congregation which will eventually lead your son or daughter to the knowledge of the Lord's great gift of salvation and a quality relationship with Him.

Office Use Only:

Pastor's Signature

Date

Date Parents Contacted:

Tentative date for this dedication:

Pastor who will perform this dedication:

Certificate Issued:

Child Dedication Application

Description

Please Fix the Following