Dedication Form

Full Name* (Please include any middle names)

How do you pronounce your child's name?

Child's Date of Birth* (DD/MM/YYYY)

Phone Number*

Email*

Mother's Full Name (Please include any middle names)*

Mother's Occupation *

Father's Full Name (Please include any middle names)*

Father's Occupation *

Address *

Gender * Gender *MaleFemale

How long have you been attending The King's Chapel? *

"We have read the Dedication information on this page and would like our child to be dedicated at The King's Chapel" (Please tick box in acknowledgement of statement) "We have read the Dedication information on this page and would like our child to be dedicated at The King's Chapel" (Please tick box in acknowledgement of statement) Mother Father