Family Dedication Registration Form By admin March 21, 2013March 28, 2013 Father’s Name: Father's Cell Phone: Mother’s Name: Mother's Cell Phone: Address: (required) Home Phone Number: (required) Primary Email Address (required) Children To Be Dedicated First, Middle, Last Name Birthdate (MM/DD/YYYY) Male or Female Please select which Family Dedication date you would like to attend: (required) Select OneSUNDAY, JUNE 16, 2013 (Father’s Day)SUNDAY, OCTOBER 13, 2013 Why do you desire to participate in the Family Dedication at Hollywood Community Church? Have you as a Father committed your life to Jesus Christ and trusted Him for salvation? Select OneYesNo Explantion Have you as a Mother committed your life to Jesus Christ and trusted Him for salvation? Select OneYesNo Explantion Are you single? Select OneYesNo Are you married parents to the child/children being dedicated? Select OneYesNo When were you married? You can enter any additional questions or comments below: For more information about Family Dedications including FAQ’s Click HERE. To download a PDF version of this form Click HERE.