Child Dedication Application Form

Personal Details (Parent)

First Name *

Gender *

Phone Number *

Home Address *

Home Address Line 2

Home City *

Last Name *

Email Address *

Mobile Number *

Date of Birth *

Home State *

Home Postcode *

Personal Details (Child)

Child's First Name *

Child's Gender *

Child's Last Name *

Child's Date of Birth *

Your Background

Do you and your spouse make the decision together and agree to dedicate your child? *

If not, please share with us the reason. *

Share with us your (and your spouse's, if applicable) spiritual journey as Christian. *

Share with us as to why you (and your spouse, if applicable) would like to get your child dedicated. *

Consent

I understand that articulating this may be an indication of my religious belief and could be considered sensitive information. I consent to this being stored by Citygate for the purpose of facilitating my next step on my faith journey. *

Agree

What Happens Next

Upon submitting this application form, one of our Supporting Pastors will reach out and schedule your child for the upcoming dedication in one of our Sunday services.