Child Dedication | Lonoke Baptist

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child DEDICATION

SUBMIT FORM BELOW

Please fill out this information about your child...

Child's Full Name*

Gender*

Male

Female

Date of Birth *

Month

Day

Year

Please fill out the following information about you and your spouse...

Mother's Name*

Father's Name*

Full Address*

Mother's Phone #*

Father's Phone # *

Contact Email*

Are you a member of Lonoke Baptist Church?*

Yes

No

We ask that you provide two (2) pictures of your baby/child. Please upload them below and then submit the form!

Picture #1

Picture #2

501-676-5136

406 West Front Street

Lonoke, AR, USA

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