HOPE COMMUNITY CHURCH Moorestown

Father's Name of Child (or Legal Guardian) * First Last
Mother's Name of Child (or Legal Guardian) * First Last
Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Number * ### - ### - ####
Email *
Child's Full Name *
Child's Birthdate * MM / DD / YYYY
Age of Child Now *
Place of Birth *
Are you currently part of a local church? *
Yes No I am a member of HOPE Community Church
If not HOPE, where?
Father's Relationship to God (or Legal Guardian)
Dad, if you were to die today, do you know for sure that you would go to heaven? *
Yes No Not Sure
If God were to ask you why He should allow you into heaven, what would you tell Him? *
Mother's Relationship to God (or Legal Guardian)
Mom, if you were to die today, do you know for sure that you would go to heaven? *
Yes No Not Sure
If God were to ask you why He should allow you into heaven, what would you tell Him? *
Your Commitment to Your Child
Please make a numbered list of at least 5 things that you intend to do to raise your child to learn about God and help nurture a relationship with Him. Do this together. Then type an asterisk (*) next to the things you’re already doing. *
We , the parents of this child, agree with HOPE’s position on Parent-Child Dedication as explained in the information packet available @ www.hope-ccm.org/parent-child-dedication
As a husband & wife please read Deuteronomy 6:5-7 and begin to seek God about these instructions.
Please list a few dates you’d like to potentially have your Parent-Child Dedication: *
How many friends/family members do you think might attend? (include yourselves) *

Enter a number value
Do Not Fill This Out

HOPE COMMUNITY CHURCH Moorestown

Father's Relationship to God (or Legal Guardian)

Mother's Relationship to God (or Legal Guardian)

Your Commitment to Your Child

As a husband & wife please read Deuteronomy 6:5-7 and begin to seek God about these instructions.