Baby Blessing Registration Form

August 20, 2026

Baby Blessing Registration Form

Please provide all of the information requested (i.e. names, place and date of birth, etc.). Pastoral counseling may be requested prior to the date of the blessing. Please note that only TWO (2) Spiritual Guardians will be listed on the Blessing Certificate.

This field is for validation purposes and should be left unchanged.

SECTION 1 – Event Information

Requested Date for Baby Blessing / Dedication:*

Enter the Email Address of the Requestor:*

SECTION II – Child Information

Name of Child:*

First Middle Last

Date of Birth:*

Name of Hospital/Birthing Center/etc. where Child was born:*

City of Birth:*

State of Birth:*

Birth Weight (lbs.):*

Please enter a number from 1 to 15.

First, enter pounds here…

Birth Weight (oz.):*

Please enter a number from 1 to 15.

…Then ounces here.

Length at Birth (in inches):*

Please enter a number from 1 to 48.

Baby's Gender:

Boy

Girl

SECTION III – Parent Information

Name of MOTHER:*

First Middle Last

At this moment, is the MOTHER currently a member of the City Tabernacle of Seventh-day Adventists?*

Yes, she is a member.

No, she is NOT a member.

Name of FATHER:*

First Middle Last

At this moment, is the FATHER currently a member of the City Tabernacle of Seventh-day Adventists?*

Yes, he is a member.

No, he is NOT a member.

Address*

Street Address Address Line 2 City State ZIP Code

Enter HOME phone number:

Enter MOTHER'S mobile phone number:*

Enter FATHER'S mobile phone number:

SECTION IV – Spiritual Guardians

Name of SPIRITUAL GUARDIAN #1:*

First Last

Name of SPIRITUAL GUARDIAN #2:

First Last