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  • Child Dedication Form

    Please complete this form if you would like to have your child dedicated at Centerpoint. If you are dedicating more than one child, fill out a separate form for each. Please be advised that your requested dedication date is not confirmed until you receive a confirmation email from Centerpoint. We ask that requests be submitted at least 2-3 weeks prior to desired dedication date. Once we receive your form, we will schedule a time for you to meet with one of our pastors, as well as with our technical team to record your dedication video. Please return form by email at info@centeringlives.com.

  • Gender

  • Date of Birth (mm/dd/yy)

  • What is your relationship to the child?

  • Are both parents Christians?

  • Are both parents members of Centerpoint?

  • Your Relationship to The Child (grandparent, aunt, uncle, etc.)

  • Are you a member of Centerpoint?

  • Due to the spiritual nature of questions asked during our Child Dedications, it is helpful for us to understand the marital status/living situation of the household. Which of the following best describes the parents'/guardians' situation?

  • Please explain

  • Preferred Dedication Date & Service Time

  • Do you need seats reserved for friends/family? If so, how many?

  • Please share any special circumstances surrounding your child.

    (for example: adoption, infertility, special needs, special meaning to name of child, etc.)

  • Please share a few of your hopes, dreams and aspirations for your child.

  • Write out a special blessing for your child, incorporating what you see in them and what you encourage them to pursue as God guides and provides.

  • Who would you like to perform your Child Dedication?

  • Please specify