"And when the days of her purification according to the law of Moses were accomplished, they brought him to Jerusalem, to present him to the Lord; (Luke 2:22, KJV).

Father's Details

Please choose a title


Please enter a First name


Please enter Surname


Please enter a valid email

Please enter some text

Please enter some text


Please enter some text


Please enter some text


Please enter some text


Please enter some text


Please enter some text


Please enter some text


Please choose a relationship status


Mother's Details

Please choose a title


Please enter a First name


Please enter Surname


Please enter some text

Please enter some text


Please enter some text


Please enter some text


Please enter some text


Please enter some text


Please enter some text


Please enter some text


Please choose a relationship status


Child's Details
Godfather

Please choose a title


Please enter a First name


Please enter Surname


Please enter a valid email

Please enter some text

Please enter some text


Please enter some text


Please enter some text


Please enter some text


Please enter some text


Please enter some text


Please enter some text


Godmother

Please choose a title


Please enter a First name


Please enter Surname


Please enter a valid email

Please enter some text

Please enter some text


Please enter some text


Please enter some text


Please enter some text


Please enter some text


Please enter some text


Please enter some text


Referee's Details

Please choose a title


Please enter a First name


Please enter Surname


Please enter a valid email

Please enter some text

Please enter some text

Thank you for completing the Child Dedication form.

All forms are handled with strict confidentiality. Your personal information will be handled in accordance with the New Wine Church Privacy Policy.

A copy of our Privacy Policy can be obtained from the church office desk or from www.newwineinternational.com

By completing this form you agree to our Privacy Policy.